Health Care

The Prospect takes on Health Care Reform

This article intends to be without bias, but the Prospect editors generally support health care reform and the public option.

Let’s begin by saying the Health Care Reform Debate is not about health care at all. It’s about paying for health care and only secondarily about actual illness and illness care. The discussion we should be having, our national obsession with doctors and death, isn’t going to happen (anywhere else: we occasionally talk about it here). It would include topics like "when is it simply cruel to prolong life". We would find that many "values" and subsequent practices find their roots not in caring for people, but in the dollar (shock!). Doctors dislike being sued, pharmacuetical and high tech equipment manufacturers like to sell products, insurance companies like to take money to protect against things they are pretty sure won’t happen, and lawyers are happy to sue everyone. These market forces, more than science, guide our health care.

But, that’s a really complicated debate, and our society and its 3 minute attention span can’t handle an actual debate about anything important.

We can barely handle what turns out to be a fairly simply question: how much healthcare should the average person expect, and how shall we pay for it?

The debate is split into many different camps, but the arguments all fall out into just a few basic themes.

In these corners: pro-reform viewpoints
On the one hand are people who are struggling under the high cost of health care. These include real people, but also legal people like hospitals, employers and government.

These people note that many Americans have no health insurance. For uninsured people, it is cheapest to wait until an illness becomes life threatening and then go to the ER. This is the most expensive health care you can have, with the poorest outcomes.

Some pro-reform groups want to reduce the cost of health care; others want to improve health care delivery for people who can’t afford the health care they need. While the two goals sound familiar, they play out very differently, since the first group wants to restrict health care and the second wants to expand it. Either way, both groups want affordable coverage for all U.S. citizens. A few even want basic health care for all humans in the U.S., an idea which drives some conservatives comically wild.

These people in general can be represented by this document HERE which is from the radical group formerly known as the American Association of Retired Persons, but now is just AARP. We encourage to you look at this document, which shows graphically why health care reform is needed, though perhaps not the health care reform we’re likely to get.

The most radical health care reform is single payer health care. Currently, in the U.S., Medicare is a single payer plan. Because single payer plans cut into the bread and butter of the insurance industry, they oppose it. Likely, however, if single payer passed, people would be able to buy private insurance as supplemental insurance, but still the industry would shrink.

The pro-reform groups have an uphill battle, because the health care insurance industry is huge and entrenched and has many powerful friends, and most of all because all the anti-groups have to do is make sure nothing happens, which is much easier than making something happen. Their biggest challenge, though, is to produce health care reform that is actually better, cheaper, and more widely accessible, instead of some ugly American mutant child that does nothing very well except give more money to corporations.

Among average persons who seem to be "pro-health insurance reform" are people who can barely afford insurance or who are already ill and broke, and those who believe basic health care is a right, and those who are simply following Obama because he’s a smart guy and they hope he knows best.

In these corners: no reform or minimal reform viewpoints
Anyone who says the U.S. has "the best healthcare on earth" better have insurance to cover mental conditions, because they’re delusional. We spend more than most countries on health care, and we do have shortages and rationing, and our health isn’t that great.

Even so, a huge number of people, nearly all conservatives, have stepped forward to complain about reform.

An odd player in this arena are the conservative Christians. At first glance, is isn’t odd, because conservative Christians as a general rule support the most restrictive social policies possible, and restricting health care falls into that. But the serious motivation for some conservative Christians is their obsession with other people’s reproduction. Many conservative Christians oppose health care reform because they are afraid little babies will be killed using public money. Killing babies with public money is against Christ’s teaching, unless they are Iraq or Afghan babies, then it’s OK, we guess, because these same groups tend to support Bush’s wars.

Because of this militant fringe, public health care probably won’t cover these kinds of gynecological health issues.

Other conservative groups weighing in are all largely representing the health care lobby, including pharmacuetical and insurance companies. Most often, these groups proclaim they are "educational" groups who are interested in "patient’s rights." One such group, Conservatives for Patient’s Rights, is headed by Richard Scott, former health care executive who was forced out because of a dirty billing scandal.

So far, it is estimated that the health care industry has spent $380 million fighting health care reform, and according to the Guardian, there are six registered healthcare lobbyists for every member of Congress. 

Currently, the big sticking point is the public option. This means that people would be able to purchase health insurance from the government, or more likely contractors with the government. The California legislature has twice passed a single payer plan for California, but the Governator, who has great health insurance, vetoed it both times.

Others are against health care reform because it makes health care affordable to the poor. That smacks of something for nothing, or worst, it sounds like freeloaders and illegal monster aliens will get all our health care. Why should a poor person have the same quality of care as a rich person?

How about this as an answer: because wealth is far more closely associated with birth, social network and luck than it is with hard work. Many of the poorest Americans are hard workers. There is nothing that makes a wealthy person morally more deserving of health care than a poor person. Anyway, there is no reason to fear on that account even under the most "liberal" health plan, the wealthy will always get better care.

Another fear is that our medical records will be in the hands of the government. That’s a pretty weak fear, though, since our medical records are already open to the government for a variety of reasons, and the Health Insurance Privacy and Portability Act was the death knell for private medical records.

Another common unsubstantiated fear is that of medical rationing, that people won’t be able to get treatment, or they’ll have to wait long times for treatment. That is a reasonable fear, but it’s what we have now, so there won’t be any significant changes there.

There’s the "six hundred dollar hammer" argument which Tom McClintock trotted out during his visit to the county the other day, implying that government can’t do anything right. There sure is evidence for that, but let’s not forget that the $600 hammer was something the Pentagon bought, and most of those warning the government can’t do anything right are happy to vote to give this same government weapons of mass destruction like nuclear bombs and stealth aircraft. If they can’t schedule medical appointments, why keep funding death from above? Who knows.

Likewise, the doctor you get seems to be important to some, and they aren’t calmed by the President’s promise that you’ll get to keep your doctor. It seems odd, again, that those who are normally against a person having the right to make medical decisions about their reproductive health are suddenly "pro choice" about what doctor you see. Most of us go to the clinic and see the doctor who has an opening, anyway. Still, this new important "choice" is a big issue.

The people who supported the $3,000,000,000,000 war in Iraq are terrified that providing health care to U.S. residents will bankrupt the nation. If that’s where our priorities lie, we’re already bankrupt.

There is actually more support for health care reform now than two months ago. Those who are against health care reform report that they are afraid they won’t get the doctor they want, or they’ll lose coverage, or those who are not well off will get coverage.

Worse than we were
Most technological nations already have some kind of single payer plan or national health care. Eventually the "leader of the free world" might, too. But that won’t be now. Now, a bill has passed out of the finance committee, known as the "Baucus Bill" for Senator Max Baucus, the committee chair. The term "ugly American mutant child health care bill" was made for this bill.

The bill, which took most of the more progressive features out of the mix, requires that all persons have insurance, but does nothing to keep costs down, and the bill doesn’t have the public option. In other words, if the insurance industry wrote a health care reform bill, it would look just like the Baucus bill. The public option is missing from the bill because Baucus, who voted against the public option each vote, wouldn’t let the bill out of committee if it had one. Not surprisingly, Baucus took $1.5 million dollars in contributions from health care companies. The full text of the Baucus bill is HERE.

This "worse off than we were" situation is why most U.S. voters are opposed to health care reform. It isn’t that we’re afraid we won’t have a competent doctor, which many of us can’t afford now, it’s that we’re afraid we’ll get a bill that takes even more and gives even less. Any bill without a public option is sure to do that.

If "competition" could really lower health care costs, it would have by now. It is true that some state insurance regulations restrain how insurance companies operate, but there’s very little evidence they would charge less without those restraints. Most likely they would simply insure only those who were good risks, and the rest of us could go hang. It’s already that way for many U.S. residents with pre-existing conditions.

A slight majority of people favor health care reform, according to the Kaiser Family Foundation though the Rassmussen report finds other results

If you haven’t seen the Micheal Moore movie "Sicko", it might be a good idea to see it. Moore is not unbiased, and he does some sensational things to highlight his point, but the movie contains a lot of reality anyway. Rent it HERE


Some "myths about healthcare reform" sites:










Website Builder