Wednesday, September 02, 2009

Healthcare Reform Fiasco
I have watched the healthcare reform discussion with fascination this summer. There is so much misinformation being thrown around. Many people that are so worked up about a government insurance plan don't seem to understand the issue. There is no bill and any healthcare reform is still working its way through both houses of Congress, and any final bill will be dramatically different than the initial proposals. People are angry about a proposed bill that is still in committee and the numbnut pundits (showing how little they know) talk about proposals like they're law.

The whole death panel discussion, in my opinion, is a canard. Any good doctor is going to have a discussion with terminal patients about their wishes - and they will and should get paid for that discussion. It's a required conversation. Why not let the patient decide rather than having a spouse or child trying to figure out what they think the sick patient would want. That's what my parents did and it made things easier. When doctors start writing living trusts and wills than it's time for concern. All I know is that I want a doctor that is going to be honest with me and tell me what I need to hear and I will be pissed off if regulation prevents this conversation.

Any government insurance plan is going to involve premiums so it won't be a boondoggle for the homeless and illegal immigrants. Plus, people that choose to be uninsured can still go to the emergency room, where they have to be seen, and cost all taxpayers money. Oh wait, that's what the uninsured do now and is one reason healthcare is so expensive. As Benjamin Franklin said 250 years ago, an ounce of prevention is worth a pound of cure.

If find it funny that old people and veterans rail against healthcare reform and government run insurance. I wonder whether they know that Medicare and VA insurance are government run insurance plans. I think it's more that they want only government programs for themselves.

The fears of rationing are overblown. Anybody that has Kaiser knows healthcare is already rationed, and I saw this first hand with both my parents. The actuarial cost of letting certain patients die is cheaper than many treatments. The small amount of lawsuits and any related settlements are dwarfed by the cost savings of not treating some sick people. No private insurance will pay for a treatment that is not covered by Medicare. For all elderly people, Medicare is the default price and treatment benchmark. That's reality.

Most pundits on the left and right don't know a damn thing about healthcare. Here is an example from Ezra Klein's Washington Post blog that blazed across the internet yesterday of CNBC's Maria Bartiromo showing her ignorance on the most basic facts about healthcare:

Why Aren't You on Medicare?

A few minutes ago on MSNBC, Maria Bartiromo and Rep. Anthony Weiner had a shouting match over universal health care. If you like Medicare so much, Bartiromo snapped at Weiner, why aren't you on it?

Weiner is 44 years old.

Update: Here's the transcript:

REP. WEINER: Listen, Carlos talks about Canada. You talk about Europe. Let's talk about the United States of America, Medicare --

MS. BARTIROMO: You have to look at where there are public plans.

REP. WEINER: No. No. The United States of America, 40 percent of all tax dollars go through a public plan. Ask your parent or grandparent, ask your neighbor whether they're satisfied with Medicare. Now, there's a funding problem, but the quality of care is terrific. You get complete choice and go anywhere you want. Don't look at --

MS. BARTIROMO: How come you don't use it? You don't have it. How come you don't have it?

REP. WEINER: Because I'm not 65. I would love it.

MS. BARTIROMO: Yeah, come on.

Yeah. Come on.

Memo to Maria: Medicare is a government health insurance program for all people over the age of 65. A 44-year-old man cannot qualify for Medicare. It is a sad state when people are getting their information from Glenn Beck, Keith Olbermann, Sarah Palin and other pundits that don't know anything about healthcare or how it's priced. All the pundits know is that if they're a Democrat any Republican proposal is bad, and if they're Republican any Democrat proposal is bad, and the more inflammatory their comments - true or not - the better . This lame-brained mentality keeps things easy for the pundits.

It is amazing to me that how few doctors, pharmaceutical company and insurance company executives are on TV discussing the reform (I am not talking about the insurance company executives defending themselves for organizing protests at the town hall meetings). They will feel the immediate impact of any reform and should have input. Most importantly would probably have the best ideas about reforms since they deal with the system every day.

I find it funny that Republicans are now screaming to defend Medicare when they have been trying to kill it since it was enacted in the 1960s. Rick Perlstein's book Nixonland has a great discussion of the virulent Republican reaction to Medicare legislation.

I wonder why there is so little discussion of tort or lawsuit reform. Malpractice insurance premiums are probably a large part of the cost of doctors' doing business. The amount of added paperwork and added steps that doctors need to go through just to avoid being sued probably also add to the cost of healthcare. Doctors should not operate under the constant threat of being sued.

It will be interesting to see how the reform efforts evolve. I hope the debate gets more substantive but don't expect it too. The House and Senate are so fractious that healthy give and take are unlikely. Clinton and Gingrich reformed welfare for the better (and Medicare, too). And Reagan and Tip O'Neil got legislation done. That's what politicians are supposed to do. Ideologues from both sides of the aisle stuck in a vacuum refusing to budge for fear of offending a small but vocal minorities within their parties are bad for the country.

Update:
The healthcare debate keeps getting crazier. An apparent belligerent anti-healthcare protester had his pinky finger bit off by a reform protester last night. The anti-healthcare guy had his finger reattached under Medicare - a government-sponsored program. I would call this irony.

1 comment:

Vernon Malcolm said...

Now that the anti-science, superstition-based initiative presidency is over, we need Manhattan projects to make us great again and boost us out of this Grotesque Depression. First we must provide free advertising-based wireless internet to everyone to end land line monopolies. Better yet, renationalize the telephone companies like in 1917 and now put them and the DTV fiasco and the internet under a renationalized post office. Then we must criscross the land with high speed rail. Because bovine flatulence is the major source of greenhouse gases, we must develop home growable microbes to provide all of our protein. Then we must create microbes which turn our sewage and waste into fuel right at home. This will end energy monopoly by putting fuel in our hands. We must finally join the metric system and take advantage of DTV problems to create a unified global standard for television and cellular telephones instead of this Anglo Saxon competitive waste. We must address that most illness starts from behavior, especially from parents. Since paranoid schizophrenia is the cause of racism, bigotry, homelessness, terrorism, ignorance, exploitation and criminality, we must provide put the appropriate medications, like lithium, in the water supply and require dangerous wingnuts who refuse free mental health care to be implanted with drug release devices. Churches should be licensed to reduce supersition and all clergy dealing with small children should be psychiatrically monitored to prevent molesting. Osama bin Laden and Timothy McVeigh were the ultimate superstition based initiatives. Aborting future terrorists and sterilizing their parents is the most effective homeland security. Preganancy is a shelfish, environmentally desturctive act and must be punished, not rewarded with benefits, preference and leave. Widen navigation straits (Gibraltar, Suez, Malacca, Danube, Panama and Hellspont) with deep nukes to prevent war. In order to fund this we must nationalize the entire financial, electrical and transportation system and extinguish the silly feudal notion that each industry should be regulated by its peers. Technology mandates a transformation of tax subsidies from feudal forecloseable debt to risk sharing equity. Real estate and insurance, the engines of feudalism, must be brought under the Federal Reserve so we may replace all buildings with hazardous materials to provide public works. Insects, flooding and fire spread asbestos, lead and mold which prematurely disables the disadvantaged. Disposable manufactured housing assures children are not prematurely disabled and disadvantaged. Because feudalism is the threat to progress everywhere, we must abolish large land holdings by farmers, foresters or religions and instead make all such large landholding part of the forest service so our trees may diminish greenhouse gases. Darwin led to the worst colonial, militarist, attrocity and stock market abuses in history - Lamarkian inhertiance and mitochondrial DNA show that Darwin was not all he is crackered up to be. We must abolish executive pay and make sure all employees in a company are all paid equally. We must abolish this exploitative idea of trade and monopoly and make every manufactured disposable cottage self sufficient through the microbes we invent. Southern Oligarchs destroyed the Democarts in the sixties and destroyed the Republicans this decade - they would not allow viable candidates like Colin Powell, Mitt Romney or Condi Rice to even be considered!