Heksefatter:
I’d like your take on [American] health care reform
Right now a lot of the kerfuffle is essentially a tempest in a teapot, because all of the kerfuffle is essentially about the public option. But here is the thing: if the public option could be measured in terms of flavourful condiments, flavorless oil being “most capitalistic” and a bottle of hot sauce labeled SUPER SUICIDE DEATH GENOCIDE SAUCE XXXXX DO NOT USE EVER WE HAVE WARNED YOU BECAUSE OUR LAWYERS MADE US WARN YOU being “most socialistic,” the public option would be, I dunno, mayonnaise. Or possibly Miracle Whip Lite.
This is because the public option has gotten so watered down at this point it is beyond stupid. To sum up: at present, it will be a government-run corporation which cannot draw on government funds to remain solvent and cannot charge artificially lower rates to be convenient to the populace at large. All it really promises to do that other insurance companies will not do is this: they promise to not screw over policy-holders. And that, that alone, has insurance companies terrified. This should tell you something.
And because of the kerfuffle over the public option and stupid Palin bullshit about death panels, the actual meat of the proposed legislation isn’t really getting discussed. These come in two flavours: the new rules forcing insurance companies to be a little less fuckersome (but not nearly so tightly regulated as in, say, Germany or the Netherlands) and the insurance subsidies for low-income families. The former are necessary and probably aren’t strict enough. The latter are necessary as a short-term means to increase coverage, but don’t address the real problem of American care, which is basically that America spends too much money on goddamn everything in health care for reasons that are almost entirely artificial, and it is bankrupting the country.
But it’s a first step, and I think a lot people boosting these policies regard it as a first step. (Not the more conservative Democrats, of course, but conservative Democrats aren’t entirely sure about whether or not we should use fire, let alone governmental answers to insurance costs.) Of course, that’s exactly why Republicans are screaming bloody murder: they know it’s a first step too. Which leads Democrats to say things like “there’s nothing inherent about these acts that will create government-run healthcare.” Which is true, but not really, you know?
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As a Brit, I’m still struggling to understand why public healthcare is viewed as anything but a good idea. I lost my job recently, after two solid years as a mid- grade taxpayer, and I’d hate to think that if I was hit by a car or something I’d go bankrupt because of a broken leg or ribs, which is my understanding of the current u.s. System. I may be wrong, we don’t have easy access to in depth info on the u.s. Social system here! I understand the idea of standing or falling by yourself is an attractive and rugged one, but surely the wealthiest (in terms of available capital) country on earth shouldn’t find itself in a situation where people avoid basic medical care because it’s too expensive? From a humanitarian point of view, isn’t that bordering on the obscene?
This isn’t about good ideas and bad ideas. This is about ideology. You’ve got a country that decided to keep fighting the Cold War twenty years after it ended. And you’ve got massive hundred billion dollar corporations that have completely usurped the power of the government.
The US is basically run by the corporations at this point, and the fact that we’re even talking about public health insurance is a political raiding of the Bastille. Why the peasants aren’t in full revolt stems mostly from right wing media. And with major weapons manufacturers – like GE and Raytheon – either owning or heavily funding the networks like NBC and CNN, while tycoons like Murdoch run their own Republican-aligned media empires, the vast majority of news media is conservative. And that means the vast majority of information flowing to the public is conservative.
And so you have a very misinformed and uneducated public leaping in fear at the idea of Canadian / British health care, because they simply don’t know any better.
This is class warfare at it’s fiercest.
Zifnab – I’d suspected as much, but I didn’t want to appear ignorant by launching into conservative bashing. It does appear that unrestricted free enterprise ultimately undermines any idea of the caring state! I’m glad to live in a society that would be regarded as unacceptably socialist by a large section of the u.s.- free medical care in return for reasonable taxes is something I’m very proud of! I’d like to hear a conservative viewpoint on this though, although I don’t think this site is the best place for that! On the other hand, if Glenn beck represents the actual normal conservative mindset… well, assuming a resoned debate using actual facts would be somewhat naive on my part, eh?
It’s funny because the essential public debate over health care boils down to wealthy, white people are afraid the government is going to have their hands in cookie jars. And conservatives are fanning these flames of fear by tossing words around like “socialism”, “death panels” and “taxes”.
The fact that every other developed country in the world has some form of socialized medicine ends up being more of a hinderence than a help. Spooky stories are being told of people dying while waiting in line for a transplant in Canada, grandmas in Britain going for weeks without their medication, etc. Of course, they conveniently ignore the thousands upon thousands of horror stories involving conventional health care in this country.
As a zifnab said, the biggest issue with long-term, meaningful health care reform is idealogical one. No longer are ideas accepted as being beneficial for the people. If a Democrat suggests something, one half of the country yelps with delight, the other half boos and hisses. Health care reform, emissions standards, taxes, whatever, we have inadvertently started a Cold Civil War.
Can we really call it class warfare when the class that is being most oppressed is by and large perfectly happy to believe everything the oppressors tell them to believe? It’s more like someone read “100 Things I’d Do If I Were An Evil Overlord”, and then decided to see if they could apply that directly to a country. It’s kind of cool, except where it’s heart-breaking and stuff.
Another big benefit of the HCR plan is the exchanges. Individuals who want to start their own businesses or freelance would be able to pool together, lowering costs. It’d be a big deal.
It’s true that there aren’t a lot of price controls right now. As hard as coverage has been, controls will be even harder. Many of the things reformers see as “waste” in the system are profit centers for docs and hospitals. It’ll be hard to cut those.
The excise taxes on high-value health care plans are one of the first ways to control costs. If employers are encouraged to buy less expensive plans, spending will go down (and the money saved on the plans will go to wages. Which is all to the better.
At this point, cost controls are a secondary concern. It’s a problem that will bankrupt the country, yeah, but the thinking is that we make coverage universal. Then, when everyone has care, we’ll be forced to deal with costs. It’s worked pretty well for Mass.
If the plan passes, the government will be paying for the health care of those other people, the ones that I don’t like.
And me. It’ll be paying for my medical care.
Oh my gosh, I’ll be one of those people I don’t like!
They don’t believe it. Large majorities support environmental protections, health care reform, and legal immigration – not to mention a host of other more nuanced financial regulations and government programs.
The public isn’t driving the ship of state anymore. There’s a dog-and-pony show with 9/12 Glenn Beck radicals and tea party protesters designed to give the illusion of public dissent. But the liberal policies won the debate years ago.
The only thing left now is hammering out details of implementation. And here we have some very broad divergences of view. But any that aren’t extremely corporate friendly die in utero. They aren’t even considered.
That’s why the House never even got to vote on a Single Payer Health Care option. That’s why we’re discussing Wall Street friendly carbon trading rather than a flat carbon tax. That’s why every stimulus ends up offering giant tax cuts for the wealthy and tax breaks for billion dollar corporations, with the debate centered on exactly how much money we can save by cutting Social Security, Medicare, and the unemployment programs.
Liberal conversation in this country is non-existent outside of a handful of fringe websites and TED talks.
Zifnab, I got to respectfully disagree. (I’m not sure how you cut it both ways, that liberal conversation in the country is non-existent, and liberal policies have won the debate.) Glenn Beck still has a huge market. Tea party protestors are for the most part real people who really believe, not corporate shills. I can think of twenty people right off the bat I know who genuinely do not believe Obama is a legitimate president, and these people are not radicals. It just depends on where you’re looking. Hell, I would say 2/3 to 3/4 of the communities in my state live in Glenn Beck/ Rush Limbaugh territory. (You don’t even want to see what the newspapers look like in my hometown; let’s just say that if I were Obama, I would not visit there, no matter how cool the bears are.)
Also, true scientific political fact: 99% of the American kitten population votes hardline Republican.
I try not to quote whenever possible, but…
“Your guilty conscience may move you to vote Democratic, but deep down you long for a cold-hearted Republican to lower taxes, brutalize criminals, and rule you like a king. That’s why I did this, to save you from yourselves. Now, if you’ll excuse me, I have a city to run.”
This is what I think whenever I listen to most americans talking politics.
I’ll try to paraphrase what I get from the conservative end of the conversation: “don’t take my money, and don’t tell me what to do. And don’t do stuff I don’t like.” I could be wrong, but it seems like most of the arguments boil down to that.
I honestly don’t believe most conservatives are speaking from an ideological standpoint anymore. They are not reacting because they believe in some kind of strict free market, because they voted for corporate bailouts and the like. They are concerned 1)That the lobbyists holding the purse strings will be upset, and 2) That Obama will actually have a political victory.
Because in an honest debate, if you have one side saying, “We want to cover the uninsured,” and you’d have another side going, “We believe in abstract free market concepts that say those people will be covered by an invisible hand” you wouldn’t really win.
So opinion seems to be divided between ‘teh corporations is evil ZOMG’ and logical reasoning that what happens is people who already have money and use that to buy powerful lobbying in congress to ensure that anything that doesn’t suit them is either shot down or mired for years or watered down so much it might as well not have passed at all…
Wait, what was the difference again?
Maybe what the world needs is for people far cleverer than anyone I’ve ever met to look at the lobby system and rejig it so amount of money available doesn’t affect how well the lobbying is received. But then, because of the lobby system that can’t happen… it’s a broken world.
“don’t take my money, and don’t tell me what to do. And don’t do stuff I don’t like.” I could be wrong, but it seems like most of the arguments boil down to that.
Yeah but that’s what all conservatives the world over say about all things – even the british conservatives use that one line for everything, and they’re the guys who’ve been using tax money to pay for their moats to be cleaned.
At some point the fundamental basis of all conservative politics was replaced by duck speak.
Quack Quack, quack, quack quack quack! 😉
*ahem* Well, I suppose if I thought about it I’m probably a “Red Tory”, and I firmly believe in minimum universal coverage for all, but as I have had the benefit of spending a year-and-a-half in Portland, OR (and the remaining couple of decades in Canada) I thought I’d present what I see as the primary attractions of the US system.
1. Tests and treatments are, in my experience, quick. Shock made a good point about media coverage often ignoring the daily tragedies, large and small, that result from a) the exorbitant cost of American health care and b) the fact many families have to cover that cost themselves. But, the flip-side is that in the Canadian people die waiting for diagnostic tests because of an excess of demand for tests compared with public dollars to fund supply. Many more people become more unwell, watch their chances of eventual recovery, and so on. Would it be right for some people to pay more to get quicker treatment *at the expense of other, less-advantaged, people*? I don’t think so. But, in a properly funded system, if someone wants to pay more (i.e. in addition to the standard taxes and health levies) to have a test or treatment done privately *and in doing so also reduce the wait-time for that treatment by people in the ‘public’ system*, then why not?
2. A public system is not well set-up to handle “marginal” treatments, and so universal health-care isn’t. Spending $500,000 on an unproven cancer treatment with an estimated 10% chance of success that may prolong a person’s life by anywhere from nothing (if it fails) to a couple of years (if it works) is not economically sound, when viewed in the context of scarce public health dollars that can save more life (in terms of time and/or people) if applied elsewhere. So, tough decisions are made about what is and isn’t covered. In the private system, those people who want to buy insurance to cover ‘every last treatment’, can do so. Those who would rather save money, don’t have to subsedise others. These latter take the risk of being… well, quite possibly in the same boat as the Canadian taxpayer, who shelled out yearly and waited in line, only to still end up bankrupt because he or she had to go abroad and pay for the treatement out of his/her own mortgage money anyway.
Of course, the calculation is always different when said people are ill… and for the majority of people for most of their lives, even some treatment is better than no treatment. Private medical facilities I’ve attended have had a sliding scale of fee depending on the patient’s income, but that doesn’t alleviate the problem with an all-private system: people end up bankrupt (and out of a job and a family) for relatively mundane illnesses.
Anyway, I’m not a health expert, but those are just my quick 2 ep worth.
“Glenn Beck still has a huge market.”
With this point being true, I’m inclined to call the American experiment a failure.
Frankly, even Beck and the tea parties are a sideshow.
It’s the weird nature of the Democratic Party in Congress- which has never approached the kind of weird ideological purity that the GOP still seems to have, let alone lockstep agreement on anything- and the fact that the private insurance companies have the goods on a lot of people in both parties.
A couple of people have portrayed this as a choice between a Socialist system and the ‘Free-Market’ system that the US currently has. I think it really needs to be pointed out that the US does NOT have a free market in medical care, and has not had one since long before I was born. What we have is a confusing tangle of contradictory regulations and Government mandates covering every aspect of the field, primarily due to Congress’s entrenched habit of trying to please every significant constituency (doctors, patients, hospitals, insurance companies, employers, drug companies)by offering something for everyone, without much effort to fit the pieces together. Listing everything wrong with the current system would take all day (longer, really), but I think probably the biggest problem is that all major employers are REQUIRED to provide medical insurance to their employees. I think this resulted from an attempt to provide an equivalent of other countries’ Socialist systems, without the appearance of Socialism. But it has been a disaster for the US. Very few people pay their own medical costs; it is done by their insurance companies, and most people don’t choose their own insurance plans, either– their employers do (and they choose the plans based on what’s the best deal for the company, not for any individual employee). So most people are two large steps removed from being in charge of their own medical care. And what this results in, is a disconnection between patients and the price of their care. This removes the primary benefit of a privately run system– the customers do not usually shop around for the best deal. This drives costs up. (In fact, shopping around is incredibly difficult in the US, because it’s almost impossible to know what the prices even are. I’m still not entirely sure why this is.)
We also have a legal system that encourages lawsuits for outrageously large sums, often based on flimsy evidence. If I’m not mistaken, doctors are usually required to have malpractise insurance, and as any economist can tell you, lawsuit insurance merely encourages more lawsuits, since inability to pay is no longer an issue. I’m not sure of the best way to limit lawsuits, because medical malpractise is one area in which big-money suits are sometimes justified. But we’ve got to at least tighten up the standards of evidence.
I’m one of the millions of Americans already benefitting from Socialised medicine. I’ve been on Medicaid since last Summer. Before that, I’d gone a few years with no insurance at all, which was very difficult as I have pre-existing conditions and some expensive prescriptions. But even so, I’d much rather have the US scrap all mandated insurance, and abolish the most of the regulations we currently have, and try to return to an actual Free-Market system. We have far too much Socialism in this country already, and letting the Government into everybody’s private medical concerns would just let them continue to erode our freedoms even farther, I think. This could very well hurt myself, I know, possibly severely. But what’s right for society, and what’s most beneficial to oneself, are not necessarily the same thing.
You’re all going to gang up on me over this, aren’t you?
This could very well hurt myself, I know, possibly severely. But what’s right for society, and what’s most beneficial to oneself, are not necessarily the same thing.
So…if you, and millions of people like you, die young or are forced into bankruptcy…well, at least it’s not happening under a socialist regime. It’s wrong for huge numbers of people but it’s right for society, whatever that means.
You know what? Ganging up on you for your ideas is pointless. I’d far rather gang up on you because you don’t know how to construct a paragraph. (Oh, I’m sorry; you must be a product of the socialist American public education system.)