Health Care: It's Not About Money

posted by Armadillo Joe

For the last couple days and to the detriment of chores and personal hygiene, yours truly has been neck-deep in a scuffle at Facebook over health care. In some ways, it is just like the one I got into back in April over torture, wherein a fairly innocuous initial comment quickly escalated into a sort of Battle Royale in the comments section because Rethugli-goon trolls are the same everywhere on the inter-webs.

The difference this time is that my opponent, while still deeply, horrifically wrong, is smart. Wicked smart. Freaky smart. This guy was the president of the debate club when we were in high-school together back during the Pleistocene Era and his cockiness back then about his quick-wittedness gave him the aire of a weird sort of jock-nerd hybrid (who looks kinda like Ed Helms). Since high school, he went to a high-end, brand-name university and then law school and works now as a high-power corporate attorney in Dallas. The fairly innocuous post I referenced above was about this NPR photo and it was like red meat to hungry wolves.

We have exchanged almost a hundred comment posts totalling probably thousands of words by now. This is also the last post up by either of us as of 4:30 pm EST today and he has yet to respond.

Other than that, I think what follows is fairly self-explanatory.

Thank you for the fraud numbers on Medicare/Medicaid. I had not seen those and I grant that they are a matter of concern, but then fraud is always a risk no matter the source of financing - private, public or some manner of hybrid. You cite the better fraud numbers for private insurance -- which I acknowledge -- as though they are their own self-evident proof of the superiority or your position. I say they are not. I don't really see how the fraud numbers in-and-of themselves themselves constitute an argument against universal health-care. If we have fraud, so what? Investigate it and punish it where necessary.

Furthermore, you continue to insist that this is ALL AND ONLY about money, money, money -- which I contend is still very, very wrong on multiple counts -- and you have not offered a single counterpoint that wasn't an argument from a financial, fiduciary or economic perspective.

If you want to make it about money, though, then OK, let's make it about money for just a little bit longer. I will say that your fraud numbers pale in comparison to these numbers (from this link: http://www.nchc.org/facts/coverage.shtml) - you can check the link for the numbered footnotes.

• The United States spends nearly $100 billion per year to provide uninsured residents with health services, often for preventable diseases or diseases that physicians could treat more efficiently with earlier diagnosis.14


• Hospitals provide about $34 billion worth of uncompensated care a year.14


• Another $37 billion is paid by private and public payers for health services for the uninsured and $26 billion is paid out-of-pocket by those who lack coverage.14


• The uninsured are 30 to 50 percent more likely to be hospitalized for an avoidable condition, with the average cost of an avoidable hospital stayed estimated to be about $3,300.14


• The increasing reliance of the uninsured on the emergency department has serious economic implications, since the cost of treating patients is higher in the emergency department than in other outpatient clinics and medical practices.11


• A study found that 29 percent of people who had health insurance were “underinsured” with coverage so meager they often postponed medical care because of costs.15 Nearly 50 percent overall, and 43 percent of people with health coverage, said they were “somewhat” to “completely” unprepared to cope with a costly medical emergency over the coming year.15

We're already spending way too much money on health-care in this country (note the numbers I cited above about the growth of the health-care sector from 10% to 16% over the last 25 years). When I advocate for universal health care, I know that nothing is cost-free -- that's not what I mean when I say money should be removed from the equation, I'm referring to the depredations of a for-profit health-care system -- I instead contend that the much-vaunted free market hasn't delivered the efficiencies its advocates have been promising us for decades, that for-profit health-care is a self-defeating contradiction and that the federal government is the only organization large and powerful enough to bring this whole mess under control and thus prevent the current financial and bureaucratic chaos from swamping our whole economy, with ruined fortunes for some and illness & death for a great many others.

I'm heartened that you agree with me that we have a problem to solve, but once again you propose the same gussied-up retread of a solution that has failed us again and again: free-markets and competition. We've tried it your way. We've been trying it your way for close on 100 years now and all it ever brought us is a mess we try mightily to clean up once a generation or so. It isn't like we don't have other models for how to structure a working universal health-care system. Other countries have ironed out the problems with the various approaches over the decades, so we should just pick one and get this stupid thing fixed. I vote for the French model and Business Week agrees: http://www.businessweek.com/magazine/content/07_28/b4042070.htm

Although the Conservative Party of Britain think theirs is pretty keen, too: http://yglesias.thinkprogress.org/archives/2009/06/conservatives-for-socialized-medicine.php

And, with the above, I'm kinda done with engaging you on the money side of this issue. If you want to keep throwing money-based arguments out there, its your prerogative but each time you do it, you reinforce my contention that this is a profoundly moral issue and the opposition are a bunch of amoral, parsimonious bean-counters who care more about protecting a status quo that works for them than recognizing the existence of a social compact which would require them to contribute to the general welfare. This is about how our values as a nation are reflected in our public policy. If money were the only issue that ever mattered, we'd still have a slave-based labor force in the south and children working 90-hour weeks in factories in the north. Sometimes issues are about more than money and when they are, we find a way to pay for what is important to us.

But before you come back at me with more sophistry about DDT or the economically disadvantaged "choosing" not to buy health coverage or what have you -- in an attempt to change the subject by force-feeding some ridiculous or distasteful false dilemma on me by skewing my positions into your own straw-man argument -- I would like you tell me precisely why you don't think this is a moral issue when millions of Americans live in fear of illness and death and economic ruin amid the general prosperity. Enough with the ad absurdum arguments. I ask you to explain why you don't think the language of morality applies on this issue.

For your side, it always and only seems to be about the money and, it seems to me, the mysterious fairy dust of free-market forces are the only mechanisms for delivery of goods and services available to policy-makers. If that is true everywhere and all the time throughout history, then why bother having a government at all?

For my side, it is about social responsibility and, as I see it, the government is the embodiment of that shared commitment to the general welfare. It is the most efficient and equitable organ for the application of our shared values. In the end, if one side contends that they don't share those values, that we can't even agree that the state of our health care system is a moral problem, then merely agreeing to disagree and moving on maintains the grossly unfair status quo. In the last 150 years, we've moved forward on slavery, suffrage, labor rights and civil rights and at every junction we did so with a wealthy opposition that cried to the heavens about the end of the world. Each time civilization survived and people continued to be rich. On this issue, too -- as it always has -- history will move forward without your consent.

Must Reads

Liberality: Note to RedState: How to Stop the Gloating

Roger Ebert: The O'Reilly Procedure

Charles M. Blow: The Purient Trap

Ezra Klein: A Question of Priorities

Isabel Macdonald: Policing the Debate on Health Reform

Robert Parry: False Health-Scare Ad on CNN

Pierre Tristam: Obama the Collaborator letting naysayers neuter health-care fix

Paul Krugman: Not Enough Audacity

President Obama's Weekly Address - June 27, 2009

Opening the Door to a Clean Energy Economy

Music Break! Michael Jackson

Normally I wouldn't do this, but this video is special to me. I was the assistant production electrician for this concert at Madison Square Garden. We worked for a solid week getting this rig together and the stars that performed that weekend included Usher, Ray Charles, Liza Minelli, Britney Spears and the rest of the Brothers Jackson. There were two concerts, one on Friday night and one on Monday night celebrating the 30th Anniversary of the Michael Jackson and The Jackson Five. After the second concert we worked all night to load out the show and ended at about 10am... on the morning of September 11, 2001.

Enjoy Billie Jean.

Michael Jackson Dead at 50

TMZ: Michael suffered a cardiac arrest earlier this afternoon at his Holmby Hills home and paramedics were unable to revive him. We're told when paramedics arrived Jackson had no pulse and they never got a pulse back.

A source tells us Jackson was dead when paramedics arrived. A cardiologist at UCLA tells TMZ Jackson died of cardiac arrest.

Farrah Fawcett Dies at 62

NY Times: Farrah Fawcett, an actress and television star whose good looks and signature flowing hairstyle influenced a generation of women and bewitched a generation of men, beginning with a celebrated pinup poster, died Thursday morning in Santa Monica, Calif. She was 62 and lived in West Los Angeles.

I had that pin up on a tee shirt when I was a kid.

Mark Sanford 2012!

Posted by Fraulein

So, looks like yet another super-smart Republican is involved in some extramarital hijinks. Is Mark Sanford's 2012 presidential exploratory committee up and running yet? God, I hope so. I want this guy right out there, front and center with Sarah Palin, Bobby Jindal, Newt Gingrich, and all the other genius bright lights of today's Republican party. Victory will be theirs!

Or not. Get your popcorn ready--the 2012 presidential race is going to be highly entertaining.

FRIDAY UPDATE: Now Sanford says he plans to reimburse the taxpayers for the cost of his little trip to Argentina. That's big of him.

The Pandemic of Stupid (Part Two: The Mark Sanford Edition)

Where in the world is South Carolina Governor Mark Sanford? The real question is, "Does anybody really care?"

This week found Gov. Mark Sanford (R-South Doucheland) conspicuously AWOL. No, seriously. No one knew where he was. Not his staff, not his wife. No one.

As the story goes, the father of four was gone since last Thursday with no mention to his wife, four sons (on Father's Day weekend) and apparently no word to his staff.

Then came this incredibly strange story from his staff that he had decided to go hiking on a Appalachian Trail, the same trail that Sanford was trying to deny stimulus money to. But still, no one was in touch with him. State Senator Jake Knotts (no relation to Don, but probably has the mentality of Barney Fife) wonders who's in charge of the Executive branch of South Carolina. Lt. Gov. Andre Bauer, the next in line for the office, doesn't even know where Sanford is.

Then this:

S.C. Gov. Mark Sanford arrived in the Hartsfield-Jackson International Airport this morning, having wrapped up a seven-day visit to Buenos Aires, Argentina, he said. Sanford said he had not been hiking along the Appalachian Trail, as his staff said in a Tuesday statement to the media.

Sanford's whereabouts had been unknown since Thursday, and the mystery surrounding his absence fueled speculation about where he had been and who's in charge in his absence. His emergence Wednesday ended the mystery.

...When asked why his staff said he was on the Appalachian Trail, Sanford replied, "I don't know."

Sanford later said "in fairness to his staff," he had told them he might go hiking on the Appalachian Trial.

Hiking in the state... Argentina... what's the difference? Now comes word that Sanford will hold a press conference at 2pm today. This thing isn't over by a longshot. Something more is going to come of this, I just don't know what yet. It seems like an awfully long way to go to hide something silly like an affair. At least the state didn't collapse without him, which is more than I can say for their financial situation with him.

UPDATE (2:33pm):

♫Don't cry for me Argentina... ♪

Sanford admits adultery and has said he will resign as Chairman of the Republican Governors' Association.

Another one bites the dust. Tell me again how marriage equality for gays would destroy "traditional" marriage and family values?

UPDATE II (3:10pm): Another example of "Fair & Balanced."

Ed McMahon Dies at 86

NY Times: Ed McMahon, who for nearly 30 years was Johnny Carson’s affable second banana on “The Tonight Show,” introducing it with his ringing trademark call, “Heeeere’s Johnny!,” died early Tuesday in Los Angeles. He was 86.

His publicist, Howard Bragman, told NBC that Mr. McMahon died at Ronald Reagan UCLA Medical Center surrounded by his family. Mr. Bragman did not give a cause of death, saying only that Mr. McMahon had a “multitude of health problems the last few months.”

Ownership

posted by Armadillo Joe

This is your official daily reminder of who actually owns this country, no matter which party may be ostensibly "in charge" of minding the store from time to time. Whether health-care or blocking the release of White House visitor logs, the reminders come in all sizes, great and small:

US seeks to stop Geronimo lawsuit

US officials are seeking the dismissal of a lawsuit brought against the government by descendants of Apache leader Geronimo to recover his remains.

The descendants want to rebury Geronimo, who was buried in Oklahoma in 1909, in his native land in New Mexico.

They are also seeking the return of body parts they say were stolen in 1918 or 1919 by a secret society at Yale University known as Skull and Bones.

[...]

The lawsuit seeks the recovery of Geronimo's remains "from 100 years of imprisonment at Fort Sill, Oklahoma, the Yale University campus at New Haven, Connecticut and wherever else they may be".

This refers to long-standing allegations that members of the Skull and Bones Society, including Prescott Bush, the grandfather of George W Bush, broke into Geronimo's tomb and stole his skull and other bones to keep in their clubhouse in New Haven.

[...]

The US justice department has now filed a motion asking a federal judge to dismiss the case.

...read more...

That would be Obama's Justice Department -- again with all of us hoping that some rogue, yet-to-be-flushed-out, left-over Bushite functionary within the department (like the DOMA brief) just reflexively operated on auto-pilot in defense of monied privilege and the status quo -- instead of simply taking no action at all and letting the suit move forward on its own, choosing to insert itself into the process, on the pretext of the the letter of the law and not the spirit of actual, you know, Justice:

Officials say the descendants' complaint does not fall within the scope of the Native American Graves Protection and Repatriation Act

Just remember that when we get into these fights over the health-care bill, Employee Free Choice, bank bailouts and CEO compensation, etc., the people who own this country are just a bunch of soulless assholes, pining away for the days of aristocracy, who really do think the rest of us exist at their pleasure, for their own private amusement, like peasants tilling the soil on the lord's land during the Middle Ages.

For them, stealing the remains of perhaps the most famous opponent of white, European settlement of North America, keeping those remains in what amounts to the Masters of the Universe's frat house to be humiliated and desecrated as befits a vanquished foe, is just how things should be. It makes digby's recent movie quote all the more poignant:

A couple of years ago Matt Damon made a movie called The Good Shepherd about the creation of the CIA. As you all undoubtedly know, for years the CIA recruited only the best and the brightest waspy ivy leaguers ... Damon's waspy, ivy league character Edward Wilson had a line that I thought rather cleverly explained how the CIA thinks of itself:

Joseph Palmi: Let me ask you something... we Italians, we got our families, and we got the church; the Irish, they have the homeland, Jews their tradition; even the niggers, they got their music. What about you people, Mr. Wilson, what do you have?

Edward Wilson: The United States of America. The rest of you are just visiting.

Where's The Left Party In America?

posted by Armadillo Joe

Yes. Yes. Yes.

Douchebag of the Week: Rep. Cynthia Davis

I really don't get some politicians. Let me rephrase that - I really don't get the callousness of some politicians. Case in point: Rep. Cynthia "Let them eat cake" Davis (R-MO). Davis is not thrilled with the latest press release from the Missouri Department of Health and Senior Services on a summer food program and has decided to comment on it.

The program provides “food during the summer for thousands of low-income Missouri children who rely on the school cafeteria for free or reduced-price meals during the regular school year.” Davis, who serves as the chairwoman of the Missouri House Special Standing Committee on Children and Families, questioned whether the program is “warranted,” and extolled the hidden benefits of child hunger:

Who’s buying dinner? Who is getting paid to serve the meal? Churches and other non-profits can do this at no cost to the taxpayer if it is warranted. [...] Bigger governmental programs take away our connectedness to the human family, our brotherhood and our need for one another. [...] Anyone under 18 can be eligible? Can’t they get a job during the summer by the time they are 16? Hunger can be a positive motivator. What is wrong with the idea of getting a job so you can get better meals? Tip: If you work for McDonald’s, they will feed you for free during your break. [...] It really is all about increasing government spending, which means an increase in taxes for us to buy more free lunches and breakfasts.

I found it hard to believe that a mother and Christian would be so flippant about a program that provides low income families healthy meals for their children during summer months when they rely on school lunch programs during the year. I went to her website to make sure she wasn't taken out of context and it was actually worse than reported. The disconnect is pretty shocking. I've captured it just in case it's removed from the site.



Maybe they shouldn't buy chips and ice cream. Can't they just get jobs at McDonald's? They'll feed you for free.

Rep. Cynthia Davis: Douchebag of the Week.

The Moral Equivalent of Slavery (UPDATED)

posted by Armadillo Joe

The so-called health care "debate" seems pretty simple to me. On one side are, well, anyone not making money off killing people by neglect -- what in a criminal trial would be called depraved indifference. On the other are the gobs of people who make gobs of money by collecting fees with the promise of paying out should the need ever arise and then not only not paying out on a wide variety of pretexts with no recourse when the need actually arises, but further revoking the policy once the person in need represents a negative income stream. In any other business such behavior would be called fraud. It is so profitable that one side can effortlessly thwart the will of an overwhelming majority of the public by spreading their blood-stained dollars around on an as-needed basis. Any politician from either party whose coffers include any money from the "Death-Insurance" industry has blood on their hands, too.

In other words, one side makes money by letting people die and anyone who helps them should be held criminally liable. It's really that simple.

But the problem we have now is that we have been robbed of the language to accurately talk about the health-care debate in the moral terms it requires. George Orwell called the phenomenon "doublespeak":

Communication will become... not the transmission of meaning, but the attempt to avoid meaning in furtherance of a political end which we feel must be mad but are unable to prove

[...]

"...the whole point of Newspeak is to narrow the range of thought... In the end we shall make thoughtcrime literally impossible, because there will be no words in which to express it” ... The lack of words to express rebellion stabilizes the regime, as no one will have the ability to revolt. However, it also takes away the basic rights of people to express their feelings and thoughts.

The GOP, through the tireless efforts of Frank Luntz and other like-minded villainous functionaries of the Ruling Elite, has been able use various methods of debate-framing to leach meaning out of the very words we use to discuss any particular issue. Hence, we are no longer "citizens" deserving of certain base-levels of protection against violence foreign & domestic and calamity economic or social for the simple fact of being citizens. We are now "consumers" of government services or any other public good, which crudely reduces health-care to a mere commodity, and commodities -- as everybody knows --- are naturally always subject to magic laissez-faire sparkle-ponies and assorted free-market fairy dust which always fixes everything for all time throughout all human history forever and ever, Amen. Duh. Anyone who says different is a commie or a Dirty Fucking Hippie and hates America. And makes baby Jesus cry.

That is how they've been able to control the health-care debate for almost a century, yes: a century, from Teddy Roosevelt's Bull Moose calling for health care reform in 1912 to FDR failing to pass NHI in the 1930's to Harry Truman running on a platform of nationalized health-care in 1948 through the modest success of the Medicare/Medicaid battles in the 60's to Ted Kennedy's heroic but doomed efforts in the 1970's and the star-crossed Clinton initiative 15 years ago. We've been fighting this battle for almost 100 years and, except for the legacy-producing aire that passed Medicare and Medicaid in the wake of the blood-sacrifice of JFK's assassination, we always lose this fight.

We're about to lose it again. In fact, I would argue we lost it when Max Baucus paid no political price whatsoever for wantonly shutting out single-payer advocates in the initial health care hearings last month. The public option is already a piss-poor substitute for single-payer, a "Separate-But-Equal" compromise that will become the doctor's office equaivalent of "white" and "colored" drinking fountains. Anyone who has ever been glared at by the checker and other people in line while trying to buy groceries with food stamps knows what I'm talking about. At this point, the public option -- if it happens at all -- will be little more than a cobbled-together false-flag hybrid so chocked full of compromises that it is essentially engineered to fail, so that the insurance industry can point to it as proof they were right all along. No good faith efforts to make health-care work for all Americans here. No sir-ee, multi-gazillion dollar CEO salaries are on the line, so shut the fuck up and stay sick and die, you Dirty Fucking Hippie.

Over at FireDogLake, Glenn W. Smith calls this situation the moral equivalent of slavery:

The gravity of America's health care crisis is the moral equivalent of the 19th Century's bloody conflict over slavery. This is not hyperbole, though the truth of it is often lost in abstract talk of insurance company profits, treatment costs, and other cold, inhuman analyses.

Today's health system condemns 50 million Americans to ill health and death while guaranteeing health care to the economic privileged. It cannot stand.

About 18,000 Americans die each year because they lack health insurance. That's more than a third the number of lives lost in battle during each year of the four-year Civil War.

Members of Congress without the moral clarity to recognize this equivalence will be condemned by history. Their spinelessness and lack of will when confronted with the power of the insurance industry is just as morally bankrupt as the American congressmen who bowed to Southern slave-owners.

[...]

In other words, people are dying because our political leaders are afraid of the insurance industry.

Condemning Americans to premature death and ill health so some can earn profits is the moral equivalent of slavery. Some may find the comparison extreme, others distasteful. But history will record it as a fact.

And members of Congress who ignore that fact can be certain that their descendants will be haunted by their blindness and cowardice.

I recognize that politics is the art of the possible. Single-payer, dissolving the corporate charters of all health-insurance companies for violations of the public good and then jailing insurance CEO's for felonious depraved indifference is a pie-in-the-sky pipe dream of this DFH in an America that still protects torturers from prosecution, but I think Obama is playing it way too safe by not providing the vocal moral leadership from his bully pulpit that would give the cowardly caucus of Democratic capitulators in Congress the political cover they need to stand with their de jure constituency instead of their de facto one.

I don't think they need a collective spine-transplant because A.) we'd need a health policy that would cover it and we don't yet have it and B.) the success of such a surgery would presuppose a desire to do the right thing. They are craven opportunists, every single one of them, and I think they need to be shamed into doing what they've been elected to do by the public, not what they've been paid to do by industry. No amount of public phonecalls and letters and emails will trump the blood-dollars poured into their pockets. The only person with the power to lead this chorus of Quislings is our president. Based on what has happened so far, I fear he will attempt to navigate a middle course where there is none.

In the meantime, just try not to get sick of anything.

UPDATED:
Over at Mahablog, it seems maha's in a pretty sour mood about how this whole health-care fight is winding down and frankly so am I. In a post titled "Reform Theater," she pretty much wrote the same post as I did, but better phrased (bold-face is mine) -

...I believe that in nearly any other industrialized democracy in the world politicians would be tripping over themselves in the rush to provide universal health care coverage for citizens.

But not in the United States. In the U.S., politicians pat us on the head and tell us we’re confused. What we really want, we’re told, is to keep the private for-profit system that allows increasing numbers of Americans to fall through the cracks.

In the United States, the will of the people means nothing any more. What was once a vibrant democracy has been riddled with parasites sucking democratic values, not to mention wealth, out of it.

[...]

At this point, most of us fully expect that President Obama’s health care proposals — which were moderate and centrist to begin with, not nearly the total overhaul most of us wanted — will be watered down and compromised away to nothing but a collection of minor tweaks. And when the health care “reform” bill is signed into law there will be a great ballyhoo about it, but the American public will see no real difference. And the struggle will continue, and the Right will argue that we tried a progressive option and it didn’t work.

[...]

Years of government that cannot be made to respond to the will of Americans has resulted in political enervation. We’ve become resigned to an ever-encroaching shabbiness, an increasingly instability. None of the promises of reform made to us by the politicians we elect are ever kept to any meaningful extent, and we no longer expect them to be kept. Instead, we get reform theater, and nothing changes. That’s just how it is.

That wasn’t always the case. I am old enough to remember the attitudes of my Greatest Generation parents and their friends, who grew up with the New Deal and fought World War II. They came out of that era believing the American people, through their government, could accomplish anything. Now we’re grateful if our lights come on and our bridges don’t collapse.

Sorry if I’m feeling bleak today, but a number of news stories say the Democrats are going to be forced to compromise away the public insurance option — you know, the option that 72 percent of Americans support — to get a health care bill passed. And as far as I’m concerned that’s the only part of the package that really matters. It’s not a perfect solution, but it would make a real difference to millions of Americans and put us on the road to more genuine reform in the future.

And of course we may ask, with such broad public support for the public option, who is forcing the Dems to compromise? And the answer is, well-funded interest groups, the over-represented Right, and Big Money generally. We won’t get the reform we need, because it would cause a few well-connected people to lose money.

[... ]

We can write letters and make phone calls and even hold massive rallies until we all grow feathers and fly. It won’t matter. We know that, because we’ve tried these things in the past, with this and other issues, and were ignored. That’s why so many of us have given up.