Friday, November 13, 2009

The basset-hound theory for opposing universal healthcare?

I can understand that some (if not many) people oppose government-run healthcare. But I continue to be amazed at the justifications you'll hear for that opposition.

One currently popular line of reasoning goes, "There's nothing in the Constitution that entitles people to free health care." And another: "It's going to come out of my paycheck, and I have a right to object to the idea of my tax money going towards someone else's healthcare." Yes, you have that right*...and no, there's nothing in the Constitution that specifically guarantees healthcare coverage. But people, please hear yourself and think about the overtones of what you're saying. Does the wo
rd callous not come to mind? And while we're talking about hearing and thinking and being callous, the other night I heard FOX's overnight sensation, Glenn Beckrecently dubbed "the Oprah" of right-wing TV for his influence over the fortunes of books he pickssay on O'Reilly's show that this whole "47 million uninsureds" thing is a canard anyway, because, Beck opined, "They'll simply go to the emergency room if They need medical treatment, and no one is going to turn Them away."** First of all, I'm not at all sure the latter half of that statement is true, at least in the sort of blanket sense that it's used by right-wing demagogues like Beck. But even if the statement were true in its entirety, one thing on which all healthcare analysts agree is that using the emergency room as your family doctor is by far the most wasteful, inefficient and ultimately unhealthy slant on healthcare. A crisis-based approach to medicine ignores today's entire emphasis on preventive healthcare, which, lo and behold, can actually (a) keep people out of the emergency room and (b) help them live longer, better, fuller lives. At lower cost to society. In the case of most major ailments, a few office-visits' worth of prevention can avert thousands upon thousands of dollars' worth of emergency cures.

Now, I guess I can see how people talk about the Constitution and tax money. But geez-Louise...how do they do so in good conscience? I'm pretty sure the Constitution doesn't address the subject of whether you can beat your basset hound, either, but what kind of person would take a stand on that "right"? As for not wanting one dime of your precious tax dollars to go towards some poor schnook's health care...exactly how self-centered are we prepared to be in this society? And to confront a subordinate argument of the above, so what if the government might make a mess of healthcare? We'd rather have millions of our fellow Americans go uninsured than have them be able to take advantage of a haphazardly administered program?

Answer me that, someone. I really want to understand.

And a final, tangentially related comment on health: Watch out for yours today on this, the third and last Friday-the-13th of 2009.

* To be clear: You have the right to dislike the idea. You do not, under the current system of government, have the right to micromanage the specific allocation of your tax dollars.
** Feel free to supply your own rationale for my decision to give these pronouns the emphasis I did.

43 comments:

Cosmic Connie said...

What is absolutely astounding to me is that so many of the folks who are hollering about their tax dollars going to someone else's health care are, themselves, sucking off the government teat in some way. Medicare. Medicaid. Social Security. Disability. Veterans benefits. And on and on and on. Others who aren't old enough or poor enough or sick enough, or otherwise unqualified for the above, have all of their needs taken care of by a "Cadillac" insurance plan and/or the largess of family members. They have a safety net, in other words, and a safe haven from which they can hurl their potshots.

The health-care proposals presented so far have made me pretty nervous too, because all of the compromises seem to give the insurance companies all the advantage, once again. Unlike many if not most of the detractors, however, I have NO safety net. Zero. And I'm tired of hearing the self-righteous wingnuts hollering about health care reforms and refusing to acknowledge that there is something seriously amiss in our health care system.

Dimension Skipper said...

"There's nothing in the Constitution that entitles people to free health care."

To which I might respond (although I never really considered it until just now)... "Well, maybe there should be?"

And if I wanted to be really snarky I'd add, "How about if we just constitutionally guarantee healthcare for any injuries or conditions which result from other constitutionally guaranteed rights?"

Maybe universal healthcare would "insure domestic tranquility." (Uh oh, right there the founding fathers said "insure." Insurance is in our country's DNA!) But I guess it's obvious from the heatedness of the ongoing public debate over universal healthcare that it probably will NOT insure domestic tranquility.

Hey, I'm no constitutional authority, I'm just exercising my 2nd and 1st amendment rights by shooting my mouth off.... Well, technically my fingers, I guess, since I'm typing this.
_____________

Sorry, once in a great while I like to don my little-used snark hat.

;-)

Also, to be fair, I don't think that free healthcare is what's under discussion or that such is in any way feasible. Most people would still be paying somewhere along the line.

The point, I'm sure, is not necessarily for it to be free per se, just more accessible and affordable with a certain limited "freeness" to those who really need care, but cannot afford it at the moment for whatever reason. Whether that comes via government payment for such folks (thus, ultimately through taxes) or privately by others who can pay essentially overpaying somewhat to protect those who can't pay much or at all... Well, that's where the debate lies.

But personally, I think you're right, Steve, that those who are against healthcare reform in any way are simply unbelievably cold and callous. If that's what they truly believe. I doubt they think of it as being callous and they probably don't even think of it much at all, but then who am I to say or judge, eh?

As always, I could be wrong or mistaken about any or all of this. Just my 2¢ at this moment in time.

As for me personally (lest there be any doubt) I am FOR any sort of healthcare reform which will allow the most people (preferably everyone) in this country to be able to seek out and obtain quality health services when or if they need them (and by "need" I mean to include basic preventive stuff like flu shots or periodical basic checkups) regardless of their own job or monetary situations. It just seems compassionately humane to me. I remain open to any path which can be shown to arrive at that ultimate destination and the sooner, the better.

Again, I'm no expert on the various proposals being bandied about, but like Connie I remain nervous and unsettled about the whole thing. I have little confidence that whatever may eventually be enacted will be much more than a bare start (if that) towards the ultimate ideal goal (again, as I see it) and will likely be grossly insufficient with no promise of being widened in scope anytime soon afterward. I hope I'm wrong.

RevRon's Rants said...

If the far right would only look a bit deeper than the shallow intellectual pool offered by the likes of Beck, O'Reilly, and Limbaugh (whose viewpoints make the insurance an drug companies positively giddy with joy), they might begin to understand that even a comprehensive public option would actually represent an economic benefit for them.

They scream about their tax dollars going to "socialist, government-run healthcare," yet ignore the fact that the average family fortunate enough to have insurance pays about $400 a month in insurance premiums. Add to that the individual's co-pay for any kind of treatment, and we're talking a significant sum, and it's going to keep climbing into the stratosphere according to even the most conservative estimates.

Under even a comprehensive public-option plan, these same individuals would see their taxes go up, sure. But the increase would be much less than even the premiums they're paying now, and the whole co-pay scenario would be eliminated.

Add to that the benefit provided to millions who can't afford insurance - much less, treatment - and it's clearly a win-win situation. But that's the core of the problem - the far right can't tolerate the possibility of those damned libruls accomplishing something that clearly benefits the populace, as such an accomplishment would be yet another nail in the coffin of the increasingly marginalized and irrelevant ideology so religiously embraced by the far right.

roger o'keefe said...

Steve, I'm glad you brought this up because it highlights an aspect of American democracy that deserves to be talked about. I would also say it shows a misunderstanding of American democracy.

The whole point of democracy is the freedom to pursue your own happiness your own way. That means that you may not like the way I choose to live or spend my money, but it's my life and my money. So you can drone about conscience and fairness or however you want to frame it, none of that changes the fact that the specifics of how a person pursues happiness were purposely left open by the Founders in order to insure freedom and personal liberty. In the same way you might not like the idea that top management at AIG are getting huge bonuses. You probably didn't even like the idea long before the company ran into trouble. You might think it's their social responsibility to spread the wealth and even things out. "Why does a person need that much money?"

Well, too bad! Questions like that have no place in our system as it was designed. Democracy doesn't stipulate that everybody gets an equal share. In fact that's the exact opposite system of government and finance. It is my right to spend my money the way I see fit (I'm just speaking hypothetically here) and you can talk all you want about how I *should* feel about fairness and how there *ought* to be more parity, but it's not your place or anyone else's to legislate that. And any steps in that direction, IMO, are contrary to everything this country stands for. When you try to legislate morality you are going down a very dangerous road.

sassy sasha said...

i totally agree steve, there's something wrong with people who begruge other people health care - and the dog is too cute!

Wandrin said...

Then there is the objection of this heading us along the path to socialism. Okay. We might already be there.... What about agricultural subsidies, water dam projects, local and state tax forgiveness for company re-locations, stimulus checks, corporation bail outs, etc.

Quoting from Obama's inaugural speech: "What is required of us now is a new era of responsibility -- a recognition on the part of every American that we have duties to ourselves...." Rather than repeating my thoughts here, that can be seen at a Wandrin blog entry: http://www.wandrin.us/blog/index.php?/archives/703-Health-A-Personal-Responsibility.html

RevRon's Rants said...

Gee, Rog... Perhaps we should legalize swindling outright, rather than merely legislate loopholes that allow the influential minority to swindle at will. After all, what right does the government have to stipulate how we get our money? That would be legislating morality, after all.

While we're on the subject of legislating morality, we seem to be quite willing to do so when other countries' governments do something we find offensive... unless, of course, it's to our economic interest to look the other way. Then, we legislate economic morality.

I would think that, as a conservative taxpayer, you would balk at the notion of executives at companies that received multi-billion dollar bailouts getting multi-million dollar bonuses for having devastated our economy. I guess there are conservatives and then there are "conservatives."

Martha said...

Okay...without getting into the whole health care thing itself, I just want to focus on one specific point that Steve raises, the Constitutionality objection:

I have not yet heard the objection that there's nothing in the Constitution that guarantees our right to health care (I'm sure that objection is out there, it's just the weakest possible argument against the current health care reform issue, so it goes in one ear and out the other) BUT

I have heard the very legitimate objection that there's nothing in the Constitution that empowers the government to impose health care on us.

Huge difference, especially with all the ramifications hanging off government-imposed health care like so many skin tags.

Speaking as a conservative (sorry, Steve), I want everyone to have what they need to be healthy and happy. And I certainly don't wish any basset hound to suffer any kind of thorough thrashing.

It's not that conservatives are against health care reform, we're just against THIS specific flavor of health care reform.

To assign conservatives the label of big fat meanies who are out of touch ("let them use the emergency room") and to all liberals the warm feelings of the milk of human kindness and lovable puppies everywhere (we already know how you feel about cats) oversimplifies the conversation. And pretty much stops it cold.

Way too naive, especially for someone of your stupendous gray matter and ability to look under the rugs to see what's really going on.

Steve Salerno said...

Martha et al: First of all, I am not mounting an affirmative argument, here, in favor of the current vision of healthcare reform (e.g. the one that just passed the House); I am reacting to the tenor of some of the opposition to universal healthcare as a whole. And I am not assigning the "big fat meanie" label to any conservative who hasn't seemingly claimed it for himself by virtue of the stridency of his own public statements on the matter (a la Rush, Beck, Hannity etc.)

Having said that, I do feel that the decision of some issues cannot be left to intellect alone. (I'm less sure of how to decide which issues those are, but healthcare strikes me as one of them.) This may sound strange, but I'm not sure intellect can be trusted. Intellect has a way of finding pretexts for ending up where it always wanted to end up on a priori basis anyway. So, e.g., if one of the questions we face is, "Should there ever be a case where an American child dies due to malnutrition?", I don't see how that question can be left to a partisan debate where the answer may be--effectively--"yes." Seems to me that certain moral human issues transcend politics and money. I don't see that as "naive," but I'm open to other views.

Steve Salerno said...

And to be more direct about the point I was trying to make obliquely via my title/illustration: I'm saying that just because something isn't enumerated in the U.S. Constitution doesn't necessarily mean it isn't a basic human right, as opposed to an American one.

Anonymous said...

Why don't people pay their own damn bills? Why don't they live within their means and buy their own insurance? Why don't they give up smoking, drinking, drugs and being so damn fat and lazy?

Poor people have poor ways. They have screwed up priorities and their stupid decisions result in pain, as stupid decisions should. I'm old enough to remember when poor people were skinny; now they are fat. They have cell phones with ring tones and cars and cable TV but no health insurance. Most poor people have very little education and even less of a work ethic. Of course they want the political elites to solve their problems. Of course they want someone else to pay their bills.

Since when do the losers get to dictate the policy for the rest of us? Losers will always trade liberty for security because they are failures at handling liberty.

The government has made a mess of the VA and Indian hospital systems: I've seen it firsthand. And the 47 million Americans with insurance number is pure BS: the S-CHIP program passed in February was supposed to supply coverage to 30 million people.

The government's solution is to fine or jail those without insurance; dictate the exact coverage you must have; cover illegal aliens; and penalize any states that try to enact tort reform for capping patient damages or lawyer fees.

If you hate the problem, just wait until you see the government's solution. Government health care just spreads the misery. It has failed everywhere it has been tried.

Steve Salerno said...

Why don't people pay their own damn bills? Why don't they live within their means and buy their own insurance? Why don't they give up smoking, drinking, drugs and being so damn fat and lazy?

Are you assuming--as you appear to be--that all uninsureds fall into all of the above categories?

Even without that assumption, it strikes me as a pretty harsh perspective on life. "There but for the grace of God" and all that.

Anonymous said...

"The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people." - 10th Amendment

Unless another Amendment is added to the Constitution that defines the "right to health care" as a something to be regulated by Congress, the entire "Health Care Debate" should be occurring at the State level... not the National one.
(The States, incidentally, are also the entities that define and enforce animal abuse issues, such as beating a basset hound.)

Them's just the rules we play by in this nation... It's also somewhat ironic to find you (of all people) arguing for doing the "feel good thing" instead of playing by the rules, Steve. For shame! ;-)

Steve Salerno said...

I've said my piece. I'll just take the blows as they come.

Martha said...

hoo dawgie...Anonymous! My oh my oh my.... you use an awfully broad brush, don't you?

To say that most poor people have little education and even less of a work ethic is to be completely out of touch with the various shades of gray and poverty in life -- no matter what the nation, no matter what the era. No matter what the economy.

I think I agree with you if what you're saying is that some people see there is more gold in them thar hills of victimhood -- and therefore choose to traffic in those patterns of choices and behaviors. I think that cashing in on society's tendency to coddle victimhood is as much a scam as anything that Steve has written about.

But please don't be so across-the-board judgmental. There are some extremely hard-working, very well-educated members of the brother-can-you-spot-me-a-dime class. And I'm afraid that there will be more before this current economic passion play plays itself out.

And you're completely wrecking my argument that we conservatives have warm hearts too.

Robert said...

Steve, let me begin by saying I appreciate your post. I agree with you that many of the right-wing "talking heads" just seize on an issue and beat it to death. Let me offer you a couple of thoughts.

One thing that bothers me is that I think we've started to redefine "universal". I heard one politician (no memory of the source) talking about covering some percentage (I think it was 95%) of people. I would like to humbly submit that any percentage other than 100% isn't doesn't qualify as "universal". A ways back I even saw part of the bill that would fine people for not having health insurance coverage (after the government made it available), and was counting on substantial revenue from said fines to bankroll part of the costs. If we're going to have measures like that, we need to realize that the proposed plan can't be "universal", as by definition there are people going without.

A second thing that bothers me is that this is frequently talked about in the name of "fairness". What proponents of the fairness angle seem to overlook is that a lot of these regulations (maximum premiums, minimum coverage, etc.) remove personal responsibility from the equation, which is anything but fair. If you exercise, eat well, and generally try to take care of yourself, it doesn't make sense to charge you the same rate (or, if it's income-based, possibly even a higher rate) than somebody that does none of those things. It's one thing to say that everybody should contribute their fair share, but I think it would be constructive to at least explore the question of what constitutes a "fair share".

There's nothing inherently wrong with wanting things to be fair, and there's nothing inherently wrong with the idea of universal health care as a concept, but if we're going to debate it and polarize people using those terms I really think that whatever solution we push forward should truly be both fair and universal.

And if we can't do that, we should have the decency to be honest about it when we're talking about it so everybody knows exactly where they stand.

Anonymous said...

I’m a New Zealander currently living in Australia. Both countries have a government funded health system which is struggling to cope with the increasing demands of an aging population, rising rates of obesity and a vast array of illnesses related to stress and unhealthy living habits ie smoking and bad food choices. Introducing a more comprehensive government operated health care system in the US would be a bandaid measure unless it is accompanied by a bigger focus on preventing illness. It amazes me that the FDA handicaps the efforts of people to stay healthy using alternative or complimentary medicine. This organization needs to be scrapped and replaced withan organization that is not in thrall to Big Pharma and the insurance industry lobbyists.

Anonymous said...

In Canada, where they have universal health care, the care is rationed and the wait for cancer treatment is usually 13 weeks or more for the first visit with the specialist. MRIs, CAT scans and advanced equipment are in short supply.

Unless you are a Bassett Hound with cancer, then you can receive your MRI or CAT Scan the same day if your owner is willing to pay for it. The Canadian government lets capitalism handle the animals, so the animals get quicker health care than the people.

Elizabeth said...

Several thoughts:

First, Anon at 4:31 -- c'mon, people, that's a satire. Right...?

Second, there is nothing in the Constitution about, for example, abortion, or gas mileage for our cars -- or cars in general, for that matter; etc. The Constitution is a living document, whose interpretation should change, within reasonable limits, with our changing times, to reflect our progress and the challenges it creates. We are a very different society from the one that existed 200+ years ago.

Third, speaking of legislating morality: conservatives, or at least right-wing Republicans, are perfectly happy legislating morality when our sexuality is concerned (e.g., abortion, gay marriage). Somebody (Begala? Carville?) quipped once that Republicans (and conservatives) want the government to get out of our lives and go where it belongs: into women's bodies. An apt, though hyperbolic summation of the right-wing political and moral philosophy, IMO.

Fourth, the issue of constitutionality (or lack of it) of health care* was taken up by constitutional scholars. See one of them and his opinion here.

Note that this is only one of many of Prof. Hutchinson's posts on the subject -- I'd encourage you to explore his blog for more.

And last, but not least: why do you hate basset hounds so much, Steve? (Kidding.:)

*Other civilized countries have the right to affordable health care written into their constitutions. It also may be useful to note that health care is a human right (and is considered as such in other democracies, those which spend about half of what we do on health care and get much better outcomes).

Elizabeth said...

Robert said, on the issue of health care, fairness, and personal responsibility:

If you exercise, eat well, and generally try to take care of yourself, it doesn't make sense to charge you the same rate (or, if it's income-based, possibly even a higher rate) than somebody that does none of those things.

It makes sense, I admit, especially when you forget that so many health problems are not related to lifestyle issues.

I cannot help but reflect on my current situation:

I don't drink, smoke, engage in any hazardous behaviors and I take a pretty good care of myself -- yet this year I was diagnosed with a brain tumor. Drats. Brain tumors are among those pesky things that have nothing to do with diet, lifestyle, etc., as far as we know.

We (husband and I) are self-employed, so we buy our own insurance, which costs us almost $1,000 a month in premiums (and I expect the cost to go up significantly next year as a "thank you" gift from my insurer for developing the brain tumor and having $120,000+ surgery to remove it). I still don't drink, or smoke, and still take good care of myself -- but, guess what, now I have this annoying pre-existing condition. Not fair.

Our premiums have been going up steadily for years, and it would make sense to get a less expensive coverage -- except that we can't, because the pre-existing condition precludes any change of insurance companies on our part (we checked).

I should add that our deductible, per person, is $10,000, so we are talking a catastrophic coverage, with the bulk of our health care expenses paid out of our pocket. Oh, and I should mention this as well: our insurance does not cover medications.

Try as I might, I cannot fit the issue of fairness into my situation (or that of a majority of uninsured and underinsured Americans). For one, I don't think it's fair that we should spend such a large portion of our income on health insurance, and have no say in it (i.e., no alternatives, other than going uninsured, which is no alternative).

I don't think it is fair we should be penalized for my illness (and we are, by no means, an exception in this situation) by being tied up to an overpriced and lousy health insurance policy, the cost of which keeps rising much faster than our earnings, which does not offer a full coverage, and which may disappear at any time at the insurance underwriter's whim. Not to mention that our insurance puts limits on our lifetime coverage, and, God forbid, should my tumor return (knock on wood), chances are I would exhaust mine rather fast (again, a typical scenario for most privately insured Americans who have the misfortune of getting sick with, say, cancer or brain injury, no matter how much they take care of themselves).

The issue of fairness here (and in the American approach to health care in general) eludes me, somehow, though Robert's initial argument makes sense, on its surface at least.

Anonymous said...

Elizabeth:

If you went uninsured, you would still be treated. Yes, the wait would be longer (but not as long as in Canada), but you would still receive treatment for your condition. Uninsured people get treated every minute of every day.

Second: the US Constitution is certainly not a living document with changing interpretations. It wasn't set up that way - principles are not subject to mob rule.

Third: life begins at the beginning. At conception, a stage all humans went through with unique DNA. I guess there is no obligation to the next generation if we snuff them out soon enough?

It looks like you have consumed more medical care than you have paid for, yet you say it's "not fair" for your insurance rates to go up. How is a subsidy to you not a handout?

Anonymous said...

Martha:
"It's not that conservatives are against health care reform, we're just against THIS specific flavor of health care reform."

For decades, conservatives have been against ANY health reform, maintaining, incredibly, that we have the best health care system in the world. Many of them still do. Only now, when the Democratic bill is actually on the table, they are ready to admit that they too are FOR the reform, just not this particular one.

Let me ask you: have you, conservatives, advocated for a health care reform at any time during the past few decades? If so, where? Somehow nobody heard your voices on the subject. Could it be because there weren't any?

RevRon's Rants said...

A few minor points:
1) Health care is already rationed in the US, with the criteria for obtaining care based upon wealth, rather than actual need. Like any finite resource, there will always be some form of rationing. Perhaps some believe that individuals with more money are more deserving of health. That's where the question of fairness arises.

2) We have the tools in this country to provide the best care in the world, yet we use them haphazardly. Those who cannot afford insurance (or treatment) go to an emergency room. In most cases, the county or state picks up the tab - often thousands of dollars - for something that could have been prevented with prophylactic care, at a fraction of the cost of an ER visit.

3) Medical bills are the single biggest cause of personal bankruptcies in the US, and affect families with insurance as frequently as those without insurance. Even folks who "did everything right" have lost everything. And don't even get me started on legislation (written in great part by the credit card industry) that eliminated even bankruptcy protection in most cases. Well, *individual* bankruptcies, anyway...

4) The Constitution is most certainly a "living document." The founders laid out the framework upon which all our laws are to be crafted, but were intelligent enough to foresee that there would be situations arising beyond their imaginings - much less, the scope of their document. The implication that the document is comprehensive to the point of all-inclusiveness is beyond absurd; it indicates either a lack of education in civics or a stubborn refusal to acknowledge truth.

5) Not being privy to the specifics of a creator's intentions, neither I nor anyone else is qualified to equivocally identify the exact moment when sentient/spiritual life begins. As such, we must each establish our own opinion, based upon our own beliefs and understanding. Thankfully, the founding fathers were wise enough to ensure that no single set of religious doctrines would be allowed to dictate how our government and legal system functions. We are each entitled to our own beliefs, but not to impose them on anyone else. A fact too frequently overlooked of late.

RevRon's Rants said...

"How is a subsidy to you not a handout?"

It's not so much a subsidy as it is an example of the insurance company losing a bet. Just like casinos, however, the bigger picture is that the "house always wins." In the case of the insurance companies, they have the "game" rigged to a degree that casinos would never be allowed to emulate, lest they be charged with racketeering. Their profit margins bear this out, and millions of Americans suffer as a result.

Cosmic Connie said...

Elizabeth, your situation starkly illustrates many of the issues that are ignored during the back-and-forth over health-care reform.

At the very core of the health care debate (and forgive me if I state the obvious, especially since it's also the main point of this blog post) is the question of whether decent health care should be considered a right or a privilege. It is possible we will never get everybody to agree on that, any more than we'll get people to agree on what is "fair," as Robert pointed out above. As Steve touched on in his post and a couple of his comments, folks even have differing views on what is meant by having a "right" to health care (legal? moral? or both?). But at the deepest level many seem to believe there is some abstract moral or divine right, no matter what the laws say.

The American Medical Association's endorsement of Obama's health care plan is a milestone in history, as the AMA has a history of being conservative and anti-reform. But even the AMA has, for a few decades at least, held to a general concept of health care as a right (although "right" is apparently ill-defined). I recently read an article in a July 1969 Time magazine describing the AMA conference that apparently turned the tide.

page 1 of the article ('Doctors' Dilemma):
http://tinyurl.com/yhv83wg
page 2:
http://tinyurl.com/ylyxbdt

This was apparently the conference in which the AMA adopted, for the first time, a proposal deeming health care to be a right rather than a privilege.

OTOH, I understand why many fear that with the current proposal we're just jumping out of the frying pan and into the fire. I also acknowledge that, as usual, many folks want to have their cake and eat it too. (Geez, Connie, what's with these cliches today?) A couple of months ago, during one of the round table discussions on ABC's "This Week," George Will noted that a big problem is that people want and expect 2009 health care at 1959 prices. But, as he pointed out, health care wasn't all that great in 1959.

And he had a point. Today's medical advances are truly astounding, and "astounding" costs money. That's the crux of the problem: advanced medical care is expensive. Preventive care is arguably less expensive, but even that costs *something,* especially if you're going to get a health-care professional in on your preventive-care plan. Someone has to pay for it somewhere down the line.

I think Ron's comment above stated many of the problems succinctly, particularly Item number 2, in which he even hinted at a solution:

"We have the tools in this country to provide the best care in the world, yet we use them haphazardly. Those who cannot afford insurance (or treatment) go to an emergency room. In most cases, the county or state picks up the tab - often thousands of dollars - for something that could have been prevented with prophylactic care, at a fraction of the cost of an ER visit."

I guess the bottom line for me is that I'm torn between a fear of (1) the government screwing things up even worse for us, while growing still more intrusive; and (2) a fear of things continuing as usual, with the insurance companies cleaning up, while far too many of us are left out in the cold. (Oops, more cliches... I must really be getting lazy. :-))

Elizabeth said...

Anon said:

If you went uninsured, you would still be treated.

And who would pay for it?

Yes, the wait would be longer (but not as long as in Canada)

Actually, no. After I was diagnosed with the tumor, I had to wait two weeks before I was seen by a specialist -- and I was lucky, because the first specialist I called offered to see me in a month (with a potentially deadly brain tumor, mind you). In contrast, in the fully socialisticky-ish British NHS, 99.9% of brain tumor cases are evaluated by specialists within 24 hours (what lowers the percentage from the full 100% is a couple of hospitals with a lousy referral rate). I highly doubt things are different in Canada. You may wait longer for elective procedures, but not in life-threatening situations. Canadians are quite happy with their medical care, as are citizens of other countries with universal single-payer health care. (And so are Americans who travel overseas, or North, and happen to experience the socialisticky-ish health care first hand. They are among the most vocal advocates of the reform here.)

BTW, you may or may not know that I was born and raised in a socialist country, and experienced first-hand the "horrors" of the so-called socialized medicine (i.e., universal government-run health care paid for by our taxes). Among them: no waiting, no rationing, no bills. It goes without saying that we had no medical bankruptcies and no medical divorces.

But we had routine house calls from our docs, when one was too sick to get to the doc's office, but not sick enough to go to a hospital. Yes, a really awful thing, all that socialized medicine.

Uninsured people get treated every minute of every day.

First, you have to be destitute to qualify for charity care; if you are not, you will be, after the hospital and docs are done collecting their bills from you.

Second, who pays for care of the uninsured and destitute? You, I, and the rest of us through our rising medical and insurance bills.

It looks like you have consumed more medical care than you have paid for

Nowhere near. We've had this policy for years (16 or so). Each year we have to pay anew over $20,000 before our insurance kicks in with its benefits. It was somewhat less in the beginning, when the premiums were not as high as they are now. But still. We've paid much more in premiums and deductibles through the years than our insurance "returned" to us through its benefits.

How is a subsidy to you not a handout?

As above, plus Ron's excellent answer.

Elizabeth said...

Ron said:

In most cases, the county or state picks up the tab - often thousands of dollars - for something that could have been prevented with prophylactic care, at a fraction of the cost of an ER visit.

Plus our ERs are crowded with people suffering from non-emergency ailments, thus diverting attention and care from life-threatening cases.

Anonymous said...

RevRon:

When Elizabeth wrote "For one, I don't think it's fair that we should spend such a large portion of our income on health insurance, and have no say in it..." she is asking for a subsidy. She has coverage, but it is expensive. And the reason why it is expensive is because she had an unforeseen medical condition which cost the insurance company significantly. And since it may come back again, the insurance company has increased her premiums. She wants relief from the taxpayers.

The insurance company lost its first bet; and it does not want to lose again. The insurance companies can't keep losing, or we all lose. Because under a state-run medical system, Elizabeth (and everyone else) would have to wait months longer for treatment. Additionally, without the "evil, greedy profit motive", medical advancements come to a halt.

I submit that Elizabeth received the full benefits of the capitalistic medical system when she needed it most; but now she does not want to pay the significant price.

Americans are capitalists when the economy is booming, and socialists when it's contracting.

ps does anyone know why the Google account setup doesn't get past my Mozilla firewall? I can never log on with my chosen google ID.

Elizabeth said...

The insurance companies can't keep losing, or we all lose.

Only if we assume that having private insurance companies is the only health coverage option available to us. It isn't, as other countries have discovered years ago.

BTW, my coverage was already very expensive before I got sick -- a situation typical for self-employed (and not only) people. Now it will become even more so.

Elizabeth said...

Because under a state-run medical system, Elizabeth (and everyone else) would have to wait months longer for treatment.

This is simply not true, as I already noted above.

I never had to wait, nor knew anyone who had to wait, for treatment in the fully socialist country under fully socialist medical care.

Here, in the US, however, I have gotten used to waiting: for doc's appointments (rarely, if ever, in the same week), for procedures (as above), in the doc's office (I "fired" several docs who have kept me waiting for over an hour, as if my time did not matter).

This was a stunning discovery to me, after moving to the US: so this is how the best health care system in the world works -- patients do not matter all that much.

Elizabeth said...

Additionally, without the "evil, greedy profit motive", medical advancements come to a halt.

Do they really? If it were so, there would be no "medical advancements" in countries that have not-for-profit health care. Again, this is not the case.

RevRon's Rants said...

"The insurance companies can't keep losing, or we all lose."

If you actually believe that the insurance companies are losing *anything,* I've got a bridge to sell you. Like I said, the house always wins, and it's difficult to reconcile the fact that the insurance companies are some of the most profitable companies in the world, while the actual services they provide are deteriorating rapidly, and by design.

As to your notion that Elizabeth wants "relief from the taxpayers," you've completely missed her point. She *is* a taxpayer. The "relief" she (like the majority if Americans) wants is relief from the predatory practices of an industry regulated according to its own standards and desires.

You can argue against universal healthcare until you're blue in the face. That won't alter the *fact* that we in the US pay far more for healthcare than any other country, yet receive health care that is inferior to many third-world countries. While the insurance companies would love to keep it that way and protect their cash cow, most Americans want it changed, so that we can actually address the well-being of our citizens more effectively than do countries that are much poorer, are much less technologically-advanced, and who are (supposedly) less compassionate than we like to claim to be.

Elizabeth said...

she is asking for a subsidy. She has coverage, but it is expensive. And the reason why it is expensive is because she had an unforeseen medical condition which cost the insurance company significantly. And since it may come back again, the insurance company has increased her premiums. She wants relief from the taxpayers.

Again, no. And no.

Insurance premiums rise for all of us much faster than our earnings, whether we get sick or not. (So do costs of medical procedures.) When we get sick, they just rise even higher, and we are unable to find an alternative, less expensive coverage or drop the existing one without risking a possible life catastrophe.

This is one of the reasons why health care costs in the US are spiraling out of control.

This is the reason (or one of them) that we spend the most in the world on health care, yet occupy only 37th place in general health outcomes.

This system is inhumane, immoral, wasteful, and, ultimately, unsustainable.

I don't want "relief from taxpayers" for myself. We have been fortunate enough to afford our lousy and overpriced insurance so far.

I want a system in which everyone would have an equal and easy access to affordable medical care; where no one would worry about whether going to a doctor is something they can afford and hope they can postpone in as long as possible; where no family would lose their home, possessions and life savings to pay for medical care; and where couples won't have to divorce to provide health care to their loved one. That's all I'm asking for. It's really not that much.

It is achievable -- other countries (less wealthy, btw) do it, why can't we*?

I am willing to pay extra in taxes for this to happen, not only for my family, but for every family and person in this country. Even for conservatives. ;)

*We can already: it's called Medicare.

Steve Salerno said...

(Rev: Cool photo. Nice "mood." But...please tell me you're not naked...)

RevRon's Rants said...

OK Steve... I'm not naked. Feel better? :-)

Steve Salerno said...

By the way, what I find genuinely compelling about this conversation beyond the literal arguments themselves is the degree to which clearly intelligent people differ with such vehemence about material facts and what those facts mean/imply. Personally, from my perspective, I am stunned at how people can be so passionate about positions I regard as indefensible. But again, let me emphasize, my point here isn't to "call out" those who differ with me, but rather to remark at how astoundingly diverse humankind is, that we can all confront the same problem, working from the same basic information, yet arrive at such antipodean conclusions--and defend them with such single-minded vigor! (I'm sure the people on the opposite side are thinking the same about me, of course.)

Elizabeth said...

Yes, that is a nice picture, Ron, I agree.

(Did you coordinate this with Steve? :)

RevRon's Rants said...

Thanks Eliz (and Steve). No coordinatin' going on, Elizabeth, but some would say that we were both "predestined" to update our profile pics. I would, of course, disagree. :-)

LizaJane said...

Roger O'Keefe - Hi. Warning - NC-17 material follows.

We have laws governing a variety of acts that present no threat to anyone but the people directly involved, but are in place purely for moral reasons. For example, sodomy laws. Who does it hurt and why does it matter if consenting adults have sex in a particular manner some folks might not approve of (in many states, sodomy laws prohibit heterosexual oral sex as well as homosexual sex*). So long as children or force are not involved, how is this anyone's business? It doesn't CONCERN anyone or cost anyone anything. It is legislating morality.

When it comes to healthcare coverage, however, there's no question -- it's a matter of money. Having a large percentage of our populace without health insurance IS costing us all. Yes, I'd agree it's a moral imperative to take care of our citizens, but that's irrelevant. The fact is we pay outrageous medical bills to treat serious diseases because we didn't think ahead and pay the much smaller bills for screening tests, nutritional counseling, smoking cessation, diabetes intervention, mental health care, etc. Yes, you can make a moral ARGUMENT for universal coverage. But the legislation itself would have nothing to do with morality. It's about the money.

LizaJane said...

Martha, hi -

We HAVE to have insurance when we drive a car so that others don't have to pay for the damage when we crash. Why don't we have to have healthcare coverage so that others don't have to pay the damage when we get sick?

How is it different for you and why do you object?

Don't you realize you're already paying for all the poor people's (and the not-quite-poor people who are dropped or unable to find coverage and can't quite afford out-of-pocket costs) coverage?

How is THIS plan so bad (not being snarky, it's a straighforward question) and what is a better alternative?

LizaJane said...

Sometimes events conspire to create disaster, Anonymous. Sometimes someone who has lived within his means and done everything by the book, finds himself out of a job, in a flooded house that's not in a flood plain, with a pregnant wife, a disabled child, an aged and sick parent, savings running out, and no healthcare coverage. They are not buying their coffee at Starbucks. They are not fat or stupid. They are in a tight spot. Temporarily. Shall we let them drown because SOME people are stupid, lazy, and abuse the system?

Furthermore, wouldn't it be a more pleasant way to live to say to yourself yeah, some people are stupid and lazy and think the world owes them something. Thank God (or dog, or The Force, or whatever) that's not me.

Some people are just incapable. Just plain idiots. Maybe they're lazy, too. Maybe they're too stupid to realize they're also fat and lazy. So what? How different would your own life be were all those fat, lazy slobs out working like eager beavers and hitting the gym? Probably not much different at all. So why spend your time and energy worrying about them? What are you so pissed off about? Just be glad you're not a stupid, fat, lazy slob, take care of them with your spare change, and go live your industrious, self-sufficient life and be happy.

Elizabeth said...

This apropos our discussion:

Insurance Runs Out For 12-Year-Old Boy Without Arm

Elizabeth said...

As The Onion would have it:

Area Man Passionate Defender Of What He Imagines Constitution To Be

ESCONDIDO, CA—Spurred by an administration he believes to be guilty of numerous transgressions, self-described American patriot Kyle Mortensen, 47, is a vehement defender of ideas he seems to think are enshrined in the U.S. Constitution and principles that brave men have fought and died for solely in his head.

Kyle Mortensen would gladly give his life to protect what he says is the Constitution's very clear stance against birth control.
"Our very way of life is under siege," said Mortensen, whose understanding of the Constitution derives not from a close reading of the document but from talk-show pundits, books by television personalities, and the limitless expanse of his own colorful imagination. "It's time for true Americans to stand up and protect the values that make us who we are."

According to Mortensen—an otherwise mild-mannered husband, father, and small-business owner—the most serious threat to his fanciful version of the 222-year-old Constitution is the attempt by far-left "traitors" to strip it of its religious foundation.


More.