Monday, March 22, 2010

Health Care Reform... it begins

I'm not thrilled with this health care reform bill. It is far too conservative for my taste. I would have much preferred a single payer system for all. I think that would be the most efficient and most effective way to address all of the issues we face. As a lesser option, Medicare for any who want it would have been my second choice. I frankly cannot see how a for profit system makes sense either economically or morally when we're talking about health care delivery. A few observations...

I am appalled at the behavior of the Republicans through this debate. As many have observed, they have used fear mongering as a way of clouding the issue and turning people away from the real questions. Some weeks ago I heard a caller on a conservative talk show make what I thought was a brilliant observation. He said, "If health care is a right, then we must pay for it as a government, regardless of what it costs. If it is not a right, then we must not pay for it, regardless of what it costs." So let me say it right out. Adequate health care is a human right and is included in the rights to life, liberty, and the pursuit of happiness. Without adequate access to health care, those rights are meaningless.

For those who yell that funding this right will bankrupt our country... I say we make decisions regarding the way we spend our money. We spend more on the military than every other nation in the world combined. And beyond direct spending on our military, since 9/11 we have spent obscene amounts of money on mercenaries who make up a significant portion of those deployed in Iraq and Afghanistan. Add to that the tax breaks that Bush gave to the wealthiest of the wealthy, driving up the deficit to where it was larger than all of the presidents before him combined... and we could have easily paid for health care for all. We make choices. They may not be easy choices but we make choices. Choosing to leave over 40 million citizens without health care is neither moral, economically sensible, or wise.

In the New York Times today, Paul Krugman showed a wonderful contrast between the leaders of the Democratic and Republican Parties. Obama, speaking to the dems said,
“Every once in a while a moment comes where you have a chance to vindicate all those best hopes that you had about yourself, about this country, where you have a chance to make good on those promises that you made ... And this is the time to make true on that promise. We are not bound to win, but we are bound to be true. We are not bound to succeed, but we are bound to let whatever light we have shine.”

He called to their best nature and to the true possibility of making this country a better place, let the political chips fall where they may.

Newt Gingrich he comments had this to say, If Democrats pass health reform,
“They will have destroyed their party much as Lyndon Johnson shattered the Democratic Party for 40 years”

by passing civil rights legislation.

I think Gingrich showed his, and perhaps his party's true colors here. If passing civil rights legislation hurt the democratic party - and it did as racism turned many against that party - they still did the right and noble thing. That Republicans used racism to further their political ends in the 60's is to their shame. If health care reform hurts the Democrats in coming elections, I am proud of them for doing what is right rather than worrying about their political futures. If the Republicans again use peoples' fears, racism, and ignorance to further their political ends... shame on them.

I continue to be amused at the videos I see of tea baggers shouting against the reforms... that many of them, perhaps even most of them are of Medicare age... and receive government health insurance. Going back to the conservative caller, if health care is not a right, then we should do away with Medicare and let those folk try to find affordable medical insurance on the free market. Hey! It would solve the problems with Social Security as well (which according to that line of thought we probably shouldn't have either) because a lot of those folk would be dying a lot sooner. (sorry for the cynicism, but it is true)

I read a conservative Christian board online every now and then and they are actually talking about secession! One of the posts, spoke about the producing states seceding, leaving behind the states that drain resources like CA to fail with a federal government that has lost its way. First, that is the stupidest thing I've ever heard. CA is not a producing state? Come on! Technology all begins here. The vast majority of fruits and vegetables grown in the US are grown here. The one industry - like it or not - that actually exports product from the US - the movie industry - is located here. I could go on. And it is one of the most frightening things I have ever heard. To take up arms because you disagree with decisions made by the properly elected leaders of the country? I don't even know what to say.

Finally, the one piece that I would recommend to Democratic policy makers is to modify the bills to bring the changes into being more quickly. The longer it takes, the more people suffer and the more easy it will be for the Republicans to continue the fear tactics.


Michael Mahoney said...

Yeah, I didn't get that "wards of the federal government thing either, and said as much.

This new law (if it gets through the Senate) will have a mountain of constitutional challenges to deal with, not the least of which is it's trying to mandate aspects of the employer/employee relationship, as well as the idea of requiring coverage, even for those who don't want it. It's a far cry from making it "available" to creating fines for those who refuse it. "Medicare for all" is a misnomer, as Medicare is an opt-in program, not a requirement.

No one in their right mind would say civil rights is a bad thing. Gingrich was merely pointing out that the fallout from the manner in which this was enacted will be wide-reaching, just as Johnson's politics damaged the Democratic party. (Johnson was known to do a little fear-mongering himself) The current administration wasted no time in saying the Bush admin "capitalized" on a national crisis to push an agenda. Yet, they proudly proclaim their own mantra - "never waste a crisis!" WHAT? "Healthcare reform" has been touted as the solution for everything from the financial crisis to herpes. Are you telling me it's not fear mongering to keep bringing up the Great Depression in healthcare discussions? What about the Gibson interview where he said that if healthcare reform isn't passed, the government will "go bankrupt" or constantly telling us that our insurance providers will drop us on a whim? That's not fear mongering?

This thing is going to drag on for years, I'm afraid, and kill the chance for any real reform. You can't lower healthcare costs by attacking those who pay for it - you have to actually lower the costs. Why are hospital visits so expensive, why are drugs so expensive, why are basic services so expensive? You wanna fix something? Fix that.

roy said...

Michael, there are certainly some places where we are on the same page... and others where we differ considerably.

"No one in their right mind..." puts a value judgment on a lot of people... I have heard lots characterize civil rights as reverse discrimination. I heard a speech by a Republican strategist, and I'm sorry that I don't know the name, who said that "Republicans" don't want the masses to vote and that the lower the turnout the better they would do. And we saw concerted efforts to disenfranchise poor black voters in the last three presidential elections. All that aside, civil rights legislation did hurt the democrats... but only because the Republicans capitalized on racism. Had the Republican leadership wielded the heavy hand they use now and said to all of their legislators, "this is the right thing to do," the political fallout would have been distributed equally. Instead the GOP played into the racism.

Fear mongering... "death panels," "government getting between you and your doctor," "socialism," "government takeover," "communism," "fascism," "government bankruptcy," etc. etc. None of those claims are true and all are aimed at making people afraid. Insurance providers dropping folk on a whim? I've known that to happen, haven't you? And the reality is that with the status quo, more and more folk would be losing health insurance as employers cannot afford it and it either was not available or is prohibitively expensive for individuals to purchase.

Again, I agree this was not the best solution even though we likely disagree on what the solution should be. And cost saving is not adequately addressed. I think physicians should be paid salaries rather than a per procedure fee. That would lessen the incentive to perform unnecessary procedures. I think we should embrace "science based medicine" where at least priority is given to tests and procedures that have scientific backing. Obama has agreed to work on tort reform and certainly there can be reasonable reform there that removes frivolous lawsuits. Better efficiency would be a significant cost savings. And remove the profit from health care. That can be done and morally should be. And moving more people into the mainstream of care moves them from the most expensive care options like the ER to physicians offices or clinics. (When we lived in Albany, many of the poor folk we knew used the ER as their primary care, usually when things had gotten fairly severe and often required an ambulance... extremely expensive option to treat something that could have easily been treated earlier in an clinic or office visit)

Michael you imply that if we had just given the issue a little more time, true reform would have come. The issue has been on the table for over 70 years. When Republicans have been in power, the issue wasn't even raised. When there was a little democratic party blip in the middle, under Clnton, and the issue was raised it was swatted down so fast and hard that politicians were afraid to even talk about it for 20 years. And the reason no Republicans voted for the current bill has nothing to do with the merits of the bill - many of the central ideas like the insurance exchange were originally proposed by Republicans - it was only about giving Obama a defeat or if not, using the issue in the next election cycle.