Socialized Medicine
This last Friday, July 17 the TEAbag people got together to complain about Socialized Medicine. The TEA (Taxed Enough Already) folks are famous for holding TEA parties to complain about taxation. (See Prospect editorial HERE). The group refers to itself as the Tea Party Patriots, TPP, which gives an active imagination a lot to work with.
The group believes in "Free Market" capitalism. "Free Market" is the belief that capitalism is, by its nature, beneficial and self-regulating. In its pure form, Free Marketism is really a kind of religion, like cargo cult is a religion. Adam Smith’s "invisible hand" of capitalism must seem like the very hand of God, descending from above to correct minor errors in judgement (naked greed) on the part of entrepreneurs and (according to TEA people,) patriots. In Wealth of Nations Adam Smith assures us that the capitalist doesn’t have to be well intentioned for the magic of capitalism to work:
By pursuing his own interest he frequently promotes that of the society more effectually than when he really intends to promote it. I have never known much good done by those who affected to trade for the public good.
Following this logic, single payer health care must seem like sin to TEAers.
But, let’s consider some of their points to try to separate faith from fact. The TPP talking points document is here.
1. Government Healthcare is a multi-trillion dollar program, which will crush an already embattled private sector economy, while government continues to grow.
It is pretty hard to wring any actual facts or arguable information from this statement. Medicare is a 1 trillion-dollar a year program, and it isn’t nearly enough, but it isn’t clear how this crushes private sector economy. Indeed, single payer health care would make life easier for SMALL businesses. Government does continue to grow, and it’s a significant problem, but let’s not cut doctors from the payroll, let’s cut cops and soldiers. Cops and soldiers also suck a huge amount of our gross national product, and they are (so far, mostly) not private sector, either. Why aren’t the TEAbaggers complaining about military spending, and cops? They grow government, and they are even less "private sector" than doctors and nurses and hospitals.
2. An estimated $68 BILLION in FRAUD every year – a shining and undeniable example of government incompetence in handling the nation’s healthcare system. The system is currently insolvent, and is projected to be completely bankrupt in seven years. Who will pay for THAT bail out? You know who…you will.
It certainly is true that medicare is a catastrophe waiting to happen, which is why we need to abandon that funding system and go to a compact, single payer plan. We were not able to verify the $68 billion, but that sounds about right. The biggest part of that "fraud" is billing error made by the bottom rung of medical billing, the county level. Much is doctors charging for procedures they don’t perform. This is to stay in business, because medicare doesn’t pay enough for a decent doctor to keep the doors open. There might be some poor people trying to get a kidney they don’t deserve, but most of the loss is administrative. You and I probably will have to pay for it, since the "private sector" has attorneys and accountants to help them not pay taxes.
Far from being a reason to abandon single payer, the shuddering infrastructure of medicare and other indigent and low-income health care is the best reason to restructure.
We’ll take the next few quickly:
3. As many as 119 million Americans could lose the coverage they have today if a government plan is introduced. Employers would be incentivized to drop private coverage, regardless of individual preferences in the matter.
Millions of Americans are losing the coverage they have now anyway, as they lose their jobs and the "private sector" slashes insurance benefits. It is entirely possible that many millions of Americans would change, not "lose" coverage. It is true they would not have "the coverage they have today", they would have different, hopefully better coverage. Also, "incentivized" isn’t a proper word, though it appears in the dictionary. It’s politico speak, turning a noun (incentive) to a verb, which should really mean, "to turn into an incentive". Sloppy language to go with sloppy logic.
Finally, the cost to business of health care is one of the primary reasons Obama wants to re-organize.
4. Bureaucrats and politicians, not families, will control health care choices and decisions. The horror stories of long waits and denied treatment in countries with government health care systems cannot be denied. Government health care doesn’t work.
Most people will continue to use the same providers they have now. There are already thousands of people in America waiting years for health care, and many of them will die before they get it. The poorer you are, the more likely you are to die of something curable. Breast cancer is a good example of a common cancer whose rates improve with consistent medical care. The government was never going to provide health care, just insurance. Most families don’t have a lot of choice now in the healthcare they get; a whole lot of people have no health care and simply wait until they are so sick they go to the ER. That isn’t cost effective. Many of those people might be eligible for subsidized health care, but they don’t know to apply.
5. Even the White House says the President's rhetoric shouldn't be taken "literally" when he promises you won't lose your current plan. They understand private insurers will be incentivized out of markets which will no longer be "free."
Still not a very good word. Most of us have no current plan to lose, or we are paying upwards of a thousand dollars a month for insurance. The government couldn’t do worse than the "private sector" has.
6. The Politicians are out of Touch - They need to get spending under control, and eliminate fraud and inefficiency in existing government programs. We need to reform what we are doing, not spend more money we don't have.
Health care has been the topic of discussion for more than twenty years now; most politicians know very well what the problem is.
It certainly is true we need to not spend money we don’t have, and a lot of that is money we don’t have going to health insurance.
What do the Toilet Paper Patriots suggest? Here is their solution:
1. Enact legislation giving families control of their health care by making insurance plans portable,
Depending on what definition you give "portable" many plans are portable now, but not nearly as portable as single payer would be.
2. Reform the tax system to allow the same tax incentives for all insurance purchasers (employers and the self employed should be able to deduct healthcare expenses),
This statement attempts to over-simplify insurance cost deductions, and considers health insurance premiums to be "health expenses". Some health insurance payments are deductible now, depending on your medical expenses. For employer provided health insurance, the costs of insurance are already a business expense. Look it up for yourself: LINK
3. Reform the litigation system to decrease inappropriate malpractice and liability claims against all facets of the medical profession and industry in order to reduce costs.
It is very difficult to sue your doctor; likely you signed a waiver and they have to literally put your heart in backwards (I know of a case, honestly) for you to be able to get anything out of your doctor. There is no doubt that lawyers, and not doctors, are the biggest curse to health care, and most everything else. Still, doctors do make mistakes, they should pay when they do, and they’ll need insurance, which will cost plenty. That doesn’t fully explain why health care costs are so high.
4. Allow the free market to deliver real competition.
That’s what we’ve been doing!
Big Government
Like the TEAbaggers, I hate big government. I hate its intrusion into families, into communities, even in to counties. I’d like the California legislature to meet every two years. I’d like them to take care of business the way a qualified administrator would take care of business. They aren’t going to do that.
Even so, the "private sector" simply won’t step forward and provide medical care to those who need it most. The government has to.
Socialista!
As I write this I enjoy socialized medicine. My care provider gives me adequate medical care for about $8.00 a visit. Because I have some health issues, my provider automatically schedules an appointment for me every three months. I see the same provider each time I go. I get a fasting blood test every scheduled visit. The care is "no frills", and there are some elective surgeries I would have to pay for if I wanted, but unless I want fuller lips or bigger teats (happening for free) my medical needs are taken care of. If I were suddenly very ill, I could be admitted to the hospital and pay pennies on the dollar. I can actually afford to get sick, which many people I know can’t.
I’m a veteran, I get my medical care at the VA hospital. True, when I was drafted I went kicking and screaming, but I risked my life for my country in the beer-halls and katzenshacks of Mainz. As a result, my needs are taken care of. Many insurance plans cover only a limited number of doctors’ visits or hospital days, exposing families to unlimited financial liability. Over half of all personal bankruptcies today are caused by medical bills. Lack of affordable health care is compounded by serious flaws in our health care delivery system. About 100,000 Americans die from medical errors in hospitals every year. One-quarter of all medical spending goes to administrative and overhead costs, and reliance on antiquated paper-based record and information systems needlessly increases these costs. Link here. On the other hand, they curse Obama for offering a system that in truth, allows people with insurance to keep their current plan, if they wish, or to upgrade or obtain insurance if they have none. It will be easier on small business, and easier on the poor. And, I’ll suggest it’s the last which really bothers the TPPatriots.
I’m getting the kind of care I want every American to get. Guess who’s running it? The Government!
Here is Obama’s logic:
Health insurance premiums have doubled in the last 8 years, rising 3.7 times faster than wages in the past 8 years, and increasing co-pays and deductibles threaten access to care.
That really answers most of the points of the TPP. It isn’t clear what the TEAbaggers want. On the one hand, they curse the "socialized medicine" we have now, when there is nothing at all stopping health insurance companies from offering appropriate coverage to the poor. Indeed, shouldn’t the "invisible hand" steer a little help to the poor and sick?