Wednesday, September 16, 2009

Walking and Chewing Gum – and – Typing and Thinking

by Chris McGinty

So I spoke with Nathan on the phone the day after President Obama’s speech. I had a lot of thoughts about the whole thing, and Nathan tried to sort of throw out what I believe to be “rhetoric to discredit” without any sort of factual or philosophical backing. My phone died, and I made the mistake of forgetting my phone charger. The last point we were on when I had to go was when Nathan asked me at what point healthcare was a “human right.”

Let’s see, in the US our inalienable rights are Life, Liberty and the Pursuit of Happiness. He’s right. As long as lack of healthcare doesn’t kill you, you still have life.

I called him back on a land line and pointed out the Hippocratic Oath, which is believed to have existed since 4 BC. Versions and variations of the oath are still used in modern hospitals. There is a loophole where if you give the patient a reference to a hospital that is better equipped to treat the patient, you can “get rid of them.” You cannot, however, outright refuse treatment in an emergency room. This is a law, and is therefore a right.

Maybe Nathan meant healthcare coverage wasn’t a human right, and this is where we get into the Blog that Nathan wrote at some point before I got home. I think his blog may have been some of the stupidest shit I’ve ever read. Well that’s not entirely true. The problem is that there is a lot of crap Nathan said while on the phone that never made it into the blog. So his blog sort of works if you didn’t hear the dumb shit he said on the phone. See Nathan, I told you my blog would make you mad, so let’s get going on this.

Nathan said over the phone that giving everyone coverage would just cause people to say, “Oh, I don’t need a job, because the only reason I had a job to begin with was to have health insurance.” And the result would be more people living on the taxpayers dollars.

Seriously.

I don’t even really know where to start here. I wish now that I had written the blog I was thinking through about: minimum wage and the new standard of two income households. It would make it easier just to refer you back to my thoughts on that while explaining my thoughts here. Now I’d just have to write a really long blog to get it all down. The problem is that if you write anything longer than a page and a half Nathan won’t read it.

So let’s deal with Nathan’s blog directly to start with and then maybe I’ll come back and deal with the phone conversation.

Point One – Nathan Doesn’t Want Obama’s Universal Healthcare: Whose universal health care would you be ok with? Adding Obama’s name was sort of unnecessary and suggests that you have a bias. Just saying. No matter how independent you claim to be, I think you’re still a Republican.

Ok, real points.

Point Two - Nathan’s Four Points: Nathan doesn’t care that not everyone has health coverage. Fair enough, because we still have it better than many third world countries. Nathan doesn’t want more government bureaucracy. Still fair, even if a bit vague. It presumes that we are creating more bureaucracy by accepting the reform plan, but it probably is so fine. Nathan doesn’t want more taxes. Who does? And I’ll deal with this later.

Finally, Nathan doesn’t give a crap about how corrupt insurance companies are. *rolls eyes* Yeah, whatever. It’s never affected him he says. *rolls eyes the other way* Because Nathan has never had to pay higher than reasonable premiums because of CEO compensation or the rising cost of health care because of unpaid treatments. If this ever does affect Nathan, Nathan will simply go to some other insurance company. And he probably will up until the point that he has a pre-existing condition that keeps him from doing so. But until then he can say, “It has never affected me.” This thin excuse for an argument might be good if he could say it never will; ever.

Point Three – Nathan Truly Believes that Most People Don’t Care that Not Everyone Has Healthcare: I truly believe that this is because most people think he’s imposing his own beliefs on the faceless masses through what’s known as presumption. So I typed in a search, and found a collection of nine polls from various sources on Pollster.com. They show a choice between controlling the cost of health care and insuring everyone. The polls are each stated differently, but give a choice between: controlling costs, expanding coverage, and unsure. Five of the nine polls are in favour of expanding coverage. The highest percentage in one poll for controlling costs rather than expanding coverage is 54%. So what does this mean? Here’s the thing, when qualifiers were thrown in to these kinds of polls that suggested that either controlling costs or expanding coverage could affect the polltaker personally and negatively the polls swung wildly. I personally believe that people are reacting out of fear.

Point Four – Nathan Thinks that the Current Administration is Blah Blah Blah, Votes and Power and Money: Again, Nathan is still a Republican.

Point Five – Nathan Doesn’t Think the Government Will Get It Right This Time: This is an interesting argument; not because it makes any sense, but because it makes no sense, yet is still widely used. The argument goes, “Look at the mess that the post office is. Look at the mess that welfare is. Look at the mess that Medicaid is. Look at the mess that Social Security is. Do we really want to pull our healthcare out of the private sector and hand it over to the government?”

This makes a weird presumption that the private sector always gets it right, and the government always gets it wrong. If not it's a false comparison. You can’t take the worst of government programs, compare them to the best private sector companies, and then go, “See!?!?!!!”

Back to the point of not wanting to pay more taxes. What of these bailouts? Whether you’re for them or against them, it wasn’t throwing more money at the post office, or at welfare, or at Social Security, or at Medicaid. It was, “Holy shit all these privately run companies are about to fail because they don’t know how to run themselves correctly.” Private sector.

Maybe you could argue that the private sector gets it right more often and that's reasonable, but the issue is that the insurance companies aren't getting it right. The basic business model for any insurance is that a group of people pay a certain amount of money into a pot and then money is paid out from that pot as needed. If a privately held insurance company cannot do the second part of that transaction, based on the signed agreement, then guess what? They ain’t runnin’ they shit right. Private sector.

And we’ve seen them flail. Here’s the sad part. The insurance companies would probably benefit from not only what Obama said in his speech, but also what the Republican rebuttal said. Because they said the same fucking thing. We need to cover everyone. They just want to go about it differently.

The Lewin group, whoever they are, published a study that proponents of Medicare have used to prove that the government does a better job of controlling health care costs, and the study shows that Medicare costs increase by 5.8% annually while private insurance costs increase by 7.4% annually. The only thing I actually care about in that statement is that medical care is significantly outpacing inflation. You have to go all the way back to 1982 to get a year in which the cost of inflation was higher than 5.8%

So how have they flailed to reduce costs? They’ve done co-pays, in-network doctors, reduction of covered health issues, and reduction of covered tests and procedures. In many other industries this constant revamping of the business in ways that profit the company, but do nothing for the consumer would cause the business to fail. But we have two choices as this industry goes. We can have health insurance, or we can risk getting sick and potentially dying. So they don’t have to care about how happy their customers are, because the customers have nowhere else to go.

If the insurance companies, the hospitals, and the doctors really wish to keep things as they are there is a very simple solution. It involves the insurance companies, the hospitals, and the doctors getting together and asking each other as well as the customer, “How can we keep everyone as healthy as possible, without going out of business?” The solutions that would come from those talks would fix the whole mess. The fact that those conversations haven’t happened is why we are where we are. And that… is your private sector hard at work.

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