Sunday, March 21, 2010

Healthcare Reform Bill Top Ten list

Here it is, just in time for tomorrow's vote on healthcare reform, the top ten reasons why this bill, weak as it is by now, needs to pass:


1. SOCIALIZED MEDICINE!!
AAaaagghhh! - Here's a tip: we already have it. We already pay for people who don't have healthcare to go to an emergency room for sniffles or care that could be provided much more effectively and less expensively in a clinic that would gladly see them if they had insurance. We already pay TOO much for that and there's no stopping it under our current "system." Ever complain about a $50 Tylenol or a $50 bandage from the ER? Guess why that is? Ever wonder why the only insurance available for a self-employed head of a healthy household costs around $500 a month JUST for catastrophic limits? (that's right, you still pay cash for every doctor visit, prescription, etc. but for the privilege of paying $500 a month, you can rest assured that at least you won't be bankrupted by a sudden illness or accident.) Why do you think that is? It's because that insurance company has "socialized" their profit by having YOUR healthy family subsidize a less healthy family. So tell me why doing that without lining the insurance company's CEOs' pockets would be such a bad thing?!

1a. - Tell me one more time why the world's richest, most free, most productive, highest GDP country is the ONLY one that doesn't provide its people with nationalized health insurance? Tell me one more time why we shouldn't be embarrassed about that rather than ignorantly insistent that what we have is better?

1b. - The DoD's (military's) Tri-Care system and the DVA's Veterans Health Administration are BOTH "socialized" healthcare systems. They are also consistently ranked among the top systems in the country for customer satisfaction, quality of care, and thriftiness. Sure, they have their occasional problems: Tri-Care is having some trouble providing consistent coverage for the "on again/off again" reservists and guardsmen who are called to active duty and then returned to their civilian lives too frequently these days, and VHA occasionally has some trouble with one or two of its 250,000 employees, but both socialized systems are far more effective than the lack of a system the rest of us have.

2. Abortion
(You're right, you're right... it looks like a silly topic to include on this list... like there's no relevance... or like any argument surrounding it is as ridiculous as some rumor you heard but ignored like "only black jazz musicians smoke marijuana" OR "Bill Gates will mail you a personal check for $400 if you complete this survey." I know, I know, but still) When it comes to the abortion argument, we need to stop the hypocrisy. Stop PRETENDING human life is sacred while we gladly support practices that end it quickly and expensively, or put profit way ahead of it - like our current model of health insurance! Don't believe me? Here are some examples: support for the death penalty or the Global War on Terrorism, opposition to helmet and seatbelt and gun laws, opposition to taxing alcohol and tobacco and junkfood, opposition to regulating giant food additive makers, oil companies and other environment destroyers. There's support for the freedom to build your house in a forest that burns regularly or on a flood plain... or any part of some other deadly natural cycle, but then the cries for help and bailouts when that natural cycle threatens your overpriced home and pets - you want us to subsidize THAT when it was your own stupid decision that put your own "sacred life" in harm's way?!
The abortion argument has about as much relevance to insurance reform as WMD had to the invasion of Iraq.
I'll grant you one little shred of connection - public money MIGHT save a mom's life by terminating her tubal pregnancy so that she can live and raise her BORN children, BUT even if we personally oppose saving that mom's life, don't we have an obligation to promote the greater good rather than childishly cling to this one little personal peeve? (I can't believe we're still talking about this.)

3. Logic
The only logical reason to support the current system is if you personally profit from it. Unless your name is among lists that include George Halvorson, Jeff Kindler, or Cleve Killingsworth, you really don't have any evidence-based reason to oppose public healthcare. Sure you can believe what Glenn Beck tells you about what it will cost, or that it's some evil liberal conspiracy, but that's all political puffery... emotional appeal... and everyone knows it. You can cite the people who complain about the system in Canada or the UK or Switzerland, but be sure to ask them if they'd trade that system while you're at it, cuz they generally offer up a quick, "no f-ing way." It's human nature to complain and there will always be anecdotal "evidence" that all systems involving humans have flaws, but those public health systems have legions of loyal supporters and they provide economic and family stability that our "system" actually seems to be destroying.

4. Portability
Tired of that dead end job, but too tied up in its insurance plan to get a new one? Thinking about starting up a small business of your own to cure cancer in your garage but know you can't afford the coverage for your kid's wheelchair batteries? Want to give up that gig at Wal-mart in order to start a non-profit that feeds and shelters homeless nuns, war heroes, and people who lost their jobs for blowing the whistle on their pedophile bosses? How great would that option be... if only you weren't beholden to your current employer's insurance plan. Sorry, your small business venture (once thought to be sacred in America) will have to take a back seat to giant insurance's profits, because that's apparently what we collectively believe in these days.

5. Profit
Yeah, speaking of that, I can't emphasize enough that there's nothing inherently evil about making a profit. I'm an American. Hell, I'm one who has signed on the line to die for my country. I believe in capitalism wholeheartedly. But I also understand that life is slightly more complex than sound bites generally allow for and thus I grasp the concept that sometimes profit and product are mutually exclusive. For instance, many aspects of health maintenance or "wellness" require long-term investments... to make it concrete let's say investments in electronic health records for example (like VHA developed and uses), or wellness exams that make use of these long-term records in order to increase a patients quality of life now and until they die. The typical insurance company only has that patient for 3-5 years, until the patient moves on to another employer-paid insurance plan. It's simply bad business for a for-profit healthcare system under our current model to invest in any kind of long term plan. it's far more profitable for them to push high-profit "treatments" or diagnostics for which they get paid now. (thus far I've picked primarily on health insurance companies, but here's where the Big Pharm gets in the game too) The bottom line is simple: AS LONG AS SOME COMPANY'S PROFIT IS THE PRIME MOVER IN THE HEALTHCARE MATRIX, YOUR HEALTH AND WELLNESS IS NOT. Perhaps healthcare is one of those things, like the military, that's best left to the non-profit realm. (Adam Smith seemed to think so)

6. The Current Model
Under our current model, an estimated 30-70 million American households are one serious illness or accident away from bankruptcy. (while the numbers are similar, we're not talking about "the uninsured" here - we're talking about people with good jobs and insurance right now) That means 30-70 million American households just one hospital stay away from shutting down a mom and pop business, or joining the welfare role, or withdrawing everything they currently buy from the national economy. Still think "socialized medicine" is a bigger threat to the American way of life? Consider the trend since you first learned how your parents' coverage worked compared to how your coverage works today. Is your policy more or less comprehensive than it used to be? Do you pay more or less of a percentage of your monthly income for that coverage. Do you pay more or less/higher or lower co-pays these days? Is that really the direction you want to keep going? If the trend continues, soon only college-aged non-smokers, non-drinkers who can prove they exercise three times per week will be able to get a catastrophic protection policy for thousands per month. The rest of us will have been deemed uninsurable for conditions like "over the age of 30" or "served in military" or "mined coal." When you speak of this current model that you so want to protect, is THAT what you're talking about? Cuz that's where it seems we're headed.

7. Socialism (not to be confused with #1 - Socialized Medicine)
The founding of this nation, to include the formation of a representative democracy as our form of government, is a socialist idea. Pooling resources for the common good is hardly a bad or ineffective or un-American idea. The Cold War is over. There really aren't any communists any more to rail against or fear, and most of the "socialists" of the world provide their people with things America simply can't figure out how to provide. So why is socialism such a bad word? And why, again, shouldn't we be embarrassed that we can't do what so many other countries do? Why can't we do it better?! Giving up on our ability to do it better than any other country seems rather unpatriotic to me. I think if we could get past this meaningless and irrelevant political debate, we'd all agree that Americans should DEMAND that our government provide us BETTER public healthcare than lesser governments provide their people!!

8. Selfishness
I want better coverage than I have now. I want my decision, or my wife's decision to leave or stay at our current jobs to be based solely on the jobs, not the insurance coverage I can't get anywhere else. I want the decisions about my healthcare to be made by my healthcare providers, NOT insurance company policy. I want my kids to focus on college when they're in college, not the fact that they will have no coverage when they turn 22. I want struggling chemists (or my mechanic, or my favorite local musician...) to be able to get a tooth replaced and get back to the lab/shop/stage rather than worrying for weeks about how they'll pay the dentist. I want dentists to focus on replacing that tooth, not how or if they'll get paid. I want my entire medical team, from physical therapists, to social workers, to surgeons to be paid for their expertise, not some code created by an insurance company. I want my neighbor's kids' asthma medicine to be as well subsidized as Viagra or Nicorette. I want my mom to be able to visit an audiologist and compare the virtues and performance of a variety of hearing aids from a variety of manufacturers rather than having to visit the retail stores/sales staff of each manufacturer. She's not shopping for a TV, but that's how hearing aid shopping works these days! What other health related issue requires you to go the Best Buy route?! Is THAT the current model of which we're all so fond?!

9. Money
Since the Reagan era, when record breaking deficit spending became the norm, we have paid more and more but expected less and less from our government. I can't live with that. Since there's no indication that we're ever going to pay less, then let's expect more. There are plenty of government managed models of successful, efficient healthcare out there, some in foreign countries with 40% income tax rates, but some right here in this country. Let's pick one, and run with it. 10 years from now, other countries will be lining up to see how they can do what we do. It will hurt a little at first, but soon we'll wonder how we ever managed to be without it. Not only that, but systems like VHA get better results and higher customer satisfaction at about 2/3 the cost of commercial systems. Why should we continue to throw that extra 33% away?

10. F the "party of No"
And I'm not just talking about Republicans here. I'm talking about anyone who votes no on issues from local school levies to national politics without offering up a better solution in place of what they're voting against. For the longest time I wasted my breath asking these folks for THEIR better ideas. A wise Republican actually pointed out to me that those kinds of people have no better ideas. They just vote no and believe they've done their part. I'm not foolish enough to believe that will ever change, nor should everyone have to have every solution to every problem in order to be justified in working to defeat an issue. But in this case, it's a little beyond granny voting down the school levy she can't afford on Social Security. The folks who vote on healthcare reform this week are paid public officials who have had since the early 90s to come up with a better plan. Their JOB is to solve this problem and they've had 20 years to come up with something more than just a NO vote. At this point, let's not let perfection be mud on the wheels of progress. Let's not let their FAILURE for 20 years prevent even a small step at a move toward a solution. Let's start with "good enough" and then work to make it better. And in the next election, let's make it better by getting rid of anyone who thinks that a NO vote is sufficient performance for the pay and the lifelong healthcare benefits we provide for them.

Luth
Out

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