August 22, 2009

Medicare for All Americans It’s always harder to gain public support when you’re pushing a positive value as opposed to a negative one. Fear is still number one. Want to pass a huge spending bill? Tell people that The Great Depression Redux is the only other option. Want to invade a sovereign nation that poses no immediate threat to our national security? Tell people that they might send over unmanned drones to spray us with Anthrax. It’s not called the Department of Defense for nothing. Many Americans get queasy when it is suggested that we use our power and resources to actively nation-build or improve living standards or do anything that isn’t framed as a defensive action aimed at eliminating a terrifying threat. This is how the debate over health care is being framed. Reform has got to be stopped because it’s a terrifying threat. It’s not a threat, of course, but the truth of the matter is as irrelevant to this debate as it was to the coverage of Anthrax drones. Well, that’s not exactly accurate. Health care reform does pose a terrifying threat... to insurance companies. Using the age-old alchemy of American industry, insurance companies have convinced large numbers of citizens that they [the citizens] have the same interest in this debate as the [insurance] companies. They don’t. I don’t. You don’t. Are you a fan of big business? That’s nice. Please, by all means, keep being a fan. But know this: your interests are not the same as theirs. Do you work for a family business? Is it your own family? If not, then don’t believe them when they say that you’re “like family.” You’re not. They’re not going to be loyal to you. They don’t care about you. They’re not even human. Really. They may be collectivist entities with the rights and privileges of humans, but they’re not actually human. Seriously. I apologize for assuming a simplistic and belittling tone, but this is actually a very important point that is easily and often forgotten. The point I’m trying to get around to making here is that insurance companies are more interested in making a profit than they are in positive health outcomes. Doctors and other health care providers are interested in making a profit too, but, unlike insurance companies, they also have a serious interest in positive health outcomes. From time to time I hear people brag about how wonderful our health care system is. I understand that. We have some fine facilities in this country. But did you know that the Mayo Clinic, one of the finest, pays its physicians set salaries regardless of assignment or productivity? It has a professional focus on health outcomes rather than fiscal bottom lines. The highest paid physician in the country (like the highest paid talk-radio host) is not necessarily the best. Remember all those folks who lauded the last few Republican Presidents (and one very ornery Vice President) for not allowing themselves to be pulled like a windsock in the direction of each new Gallup poll? Well, where are the encomiums of that leadership model now? It seems that they have withered a bit under the righteous onslaught of town-hall protests and “tea parties,” no? The government, I hear, is too incompetent to run “Cash-for-Clunkers” or the Post Office, let alone a single-payer health care system. I’m hearing this, oddly enough, from the same people who frantically insisted that I trust the government to run secret CIA prisons, detain “enemy combatants” indefinitely and without trial (or even a writ of habeas corpus), pillage my phone, Internet and library records, and capriciously unleash the hounds of war. Forgive me if I don’t take these people seriously. The interest in killing comprehensive health care reform is coming from those who are benefiting the most from the status quo. The insurance industry is using its leverage as a large corporate concern with its ideological allies in the conservative movement to foment resistance. This is unequivocally true and unsurprising to the point of being blasé. The interests of Pfizer and Kaiser Permanente are as transparent as those of Sean Hannity or Britney Spears. What are your interests? Do you want your health care to be forever coupled with your employment situation? Do you want insurance providers to have the right to deny you coverage based on their own actuarial calculations? During much of this last decade I’ve had top-of-the-line health care coverage through my employer. It was terrific. My employer paid a huge sum every month and all my health care needs were met. These years spanned my late 20s through my mid 30s: I was healthy. I didn’t need serious medical attention. Then I got laid off. Did I accrue any interest or equity or savings towards future health care costs during that time? No. The insurance company just pocketed untold thousands and that was that. I had box of knick-knacks and a cold goodbye. I suppose medical bills will one day gobble up my 401(k), but that’s not what it’s intended for. I also paid into Medicare, Medicaid and Social Security… and those payments still make sense to me. I still own a piece of that. I’ve always wanted to go to Tuscany, so I’ve been reading a book about traveling in Italy. I came across this passage earlier today: If you are in need of urgent medical attention, go to the Pronto Soccorso (outpatients) department of the nearest main hospital. Patients staying in hospitals are expected to supply their own cutlery, crockery, towels and toilet paper, but not bed linen. The nursing staff will also expect either friends or relatives to help feed and wash hospital patients. I remember reading tips from 20 years ago on how to keep health care costs down. Eat your own food. Bring your own aspirin. Use your own [insert commonplace item here]. We need a more affordable, saner health care system. We can decide to live in a country where every injury doesn’t spark a lawsuit instigated...

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