Thursday, July 23, 2009

The health care debate explained

The amount of money we spend as a nation on health care is going to double in the next 10 years. 14,000 people lose their health insurance every day. Forget quitting your job if you have something wrong with you; you'll never get insured again. HALF of all bankruptcies are due to medical bills.

There is something, perhaps, wrong with the health care system in this country. And it's so big, and so unwieldy, that obviously something needs to be done at the national level.

What SHOULD happen is that Congress passes some kind of comprehensive health care bill that will allow every person in this country to have access to health care at a reasonable rate that he or she can afford. It better include some kind of preventive care incentive and probably needs some price controls. As part of my job, I sometimes have to look at medical records, and I was just looking at one itemized bill that listed hydrocodone tablets (i.e., Vicodin) at 18 dollars each in this particular hospital. When you can get a prescription filled at Wal-Mart for FOUR BUCKS, there's something seriously fucking wrong with this picture.

What WILL happen is that Congress will pass some sort of watered-down, cobbled-together mess that won't work and will cost way, way, way more money that anyone can imagine and that everyone will hate. There are a couple of reasons for this:

(1) Members of Congress are basically owned by, and beholden to, lobbyists and major donors, and do you think those lobbyists and/or donors are people who have just gone bankrupt due to medical bills? BZZZZZZZT MOVE TO THE BACK OF THE CLASS PLEASE. Do you think maybe it's health insurance companies and doctors and people who make $18 vicodins? BING BING BING BING YOU WIN A GIANT STUFFED PANDA.

(2) Plus, you got the right-wing crazies out there like the guy I heard on radio yesterday saying that Obama is like Hitler (no joke) because the health care bill encourages old people to kill themselves. THE HOST OF THE RADIO SHOW AGREED WITH HIM. I've got to scour this bill and find that provision now. These nutbars are fucking loudmouths and people (i.e., Republican politicians) pay attention to them and they influence national policy to some extent as a result.

(3) Then there's the fact that you could easily set up a national health insurance plan and charge people between 1 and 2.5% of their income for it and everyone could be covered but no one wants to talk about what would be considered a new tax and plus the insurance companies are all like "WAHHHH WAHHH IT'LL PUT US OUT OF BUSINESS" and wouldn't that just be the saddest day? Because your health insurer is your BIGGEST BESTEST FRIEND and wants nothing more than to give you all the delicious health care you need.

So we'll get the plan we deserve. It won't work, you won't be covered, and it's going to cost more than 3500 gold-plated F-22 fighters with a DVD player and a bidet.

3 comments:

owen_45 said...

“As part of my job, I sometimes have to look at medical records, and I was just looking at one itemized bill that listed hydrocodone tablets (i.e., Vicodin) at 18 dollars each in this particular hospital. When you can get a prescription filled at Wal-Mart for FOUR BUCKS, there's something seriously fucking wrong with this picture…

…because your health insurer is your BIGGEST BESTEST FRIEND and wants nothing more than to give you all the delicious health care you need.”

Sounds like it’s a hospital thing – charging top dollar for something to get the maximum rebate from the insurance co., eh? Then again, I think Wal-Mart offers the generics.

“Then there's the ‘fact’ that you could easily set up a national health insurance plan and charge people between 1 and 2.5% of their income for it and everyone could be covered but no one wants to talk about what would be considered a new tax and plus the insurance companies are all like "WAHHHH WAHHH IT'LL PUT US OUT OF BUSINESS" and wouldn't that just be the saddest day?”

If factual, how would this “easily” be set up? Let’s say, there are 8 million legal Americans who have serious disabilities from birth and born into low income families. In the goodness of my heart, I am personally willing to contribute to this (though I respect that not everyone must be made to participate). However, a mandatory plan is a soft tyranny. It makes me pay for every non-tax paying illegal, every hypochondriac, everyone in need of an “intervention” a la a bunch of free Vikes and so forth. While liberalism is based on “fairness,” this plan isn’t fair. Let’s say I’m 25 and I don’t want to pay. What then? I get a hefty fine that seriously impacts my recreational medical weed budget. Seems like anything legislature sets up gets bloated, corrupted, and abused by some beaurocratic panel. That 1 to 2.5% won’t stay that way very long.

I think we agree that a plan left to legislature will suck. Do we agree? Because on one hand you are advocating statism (“everyone could be covered but no one wants to talk about what would be considered a new tax”) and on the other, you don’t trust the state (“we’ll get the plan we deserve”).

Or were you just having a bad day?

TK said...

Owen -

1. I don't care if it's the hospital or the insurer who's paying $18 for a Vicodin. In the end it's you and me paying that. My point was that some kind of cost control is needed.

2. I'm not talking about any kind of mandatory plan. Just a new insurance system run by the government. Don't want to be part of it? Don't join. Keep your current insurance. I never advocated for any kind of mandatory plan.

Of course, if you choose not to participate in any plan, and burst a blood vessel in your brain yelling about Obama's birth certificate and have to go to the emergency room, who's gonna pay for that? Oh yeah, me, the taxpayer. So thanks a lot.

3. I don't know what the definition of "statism" is, even though it gets tossed around on right-wing radio a lot, so I don't know if I'm for it or not. I know that I've read studies about how the gov't could set up a basic insurance plan that anyone could join for a relatively low fee, and all I'm saying is that's worth talking about.

Of course I don't trust the government as it currently exists. But it's the only one we've got and so we pretty much have to live with it.

4. As long as there's a beer at the end of it, I never have a bad day.

tomneuman said...

Facts: The Scourge of Liberal Dogma

Under your plan of charging every American 1% - 2.5%, with a median income of roughly $50,000 per year (2007 Census) each American will pay $83.33 per month for socialized healthcare coverage (2%).

May I suggest another solution?

Within an U.S. population of 300 mil. (2007 Census), 270.3 mil. are cell phone subscribers (CTIA). Thus, of the 46 mil. uninsured, 19 mil. have cell phones with an avg. cell bill of $73.00 (JD Power). Then we have the 43 mil. smokers in this country 50% of who make less than 200% of the Federal poverty line (US Dept. Hlth & Human Serv.). This poor or nearly poor population spends on avg. $136/month for cigarettes (CDC). What if these 21.5 mil. people budgeted that $209/month toward health care insurance? I know-require people to exercise self-discipline and sacrifice = mean spirited conservative.

I realize this isn’t the solution, but why is it that most liberals consider the Federal government to be a panacea of efficiency and cost reduction? When has any public or private endeavor met the rigors of market dynamics without the forced bureaucratic constraints and cost discipline of competition? Don’t believe the stretched truth that we can keep our private carriers and a gov. healthcare insurance will compete on the same playing field as private insurance. The lifeblood of private business is profit, in many ways determined by product pricing and cost control, without which an entity cannot survive. The gov. has none of the profit-loss rules to keep it viable in a truly competitive market and any artificial cost control will simply lead to a reduction in the quality of care. Nobody will shut the doors on Gov. Healthcare, Inc. if they lose money because of a poorly priced product or out-of-control costs. They will simply print more money or tax the “rich” (the apparent preferred method). How many private companies can compete with that business model and how many will survive? What will remain when private insurance becomes unsustainable? How’s this for bureaucratic efficiency: I saw a report on CNN recently, that replacing a standard wheelchair for the typical Medicare patient cost U.S. taxpayers $1200 per chair. The reporter found the same chair ordered from the manuf. for $350 and then found one on e-bay for $275. I agree that politicians are beholden to lobbyists and special interest groups. More reason to prevent those same politicians from controlling a $2.5 trillion dollar health care system.

You ask about “statism”? Here is as good a description as can be found in this quote of the 19th century historian, Alexis de Tocqueville from his “Democracy in America” (1835):

"The sovereign extends its arms about the society as a whole; it covers its surface with a network of petty regulations—complicated, minute, and uniform—through which even the most original minds and the most vigorous souls know not how to make their way… it does not break wills; it softens them, bends them, and directs them; rarely does it force one to act, but it constantly opposes itself to one's acting on one's own … it does not tyrannize, it gets in the way: it curtails, it enervates, it extinguishes, it stupefies, and finally reduces each nation to being nothing more than a herd of timid and industrious animals, of which the government is the shepherd."

Of course, I can only assume an argument for self-reliance, restraint, self-discipline and smaller government makes me a right-wing radio talk show host. I gladly wear that label before left-wing radical socialist progressive. Looks like you have a little more work to do before claiming to have an explanation of the healthcare debate.

BTW – How many times did I have to listen to Hitler references (no joke) when liberals complained about Bush? Get over it.