Friday, September 18, 2009

Why the Health Care Debate Sucks

God knows the last thing the internet needs is another uninformed blogger blathering about health care, but it's my mandate to write about things that suck, and there's no way that I can ignore one of the suckiest issues of our time. Actually, I consider myself only semi-uninformed: I recently read an interesting book--Who Shall Live? by Victor R. Fuchs--that examined the sad state of health care in the US. The book was published in 1974, but many of Fuchs's remarks apply to the present day as well-- which proves that punk rock did not change the US health care system as promised. As a guide to the ongoing clusterfuck that is America trying to decide something, I've provided a list of seven quotes from Who Shall Live? that show why, exactly, the health care debate in America got so totally Fuched.

1."In medicine, the crisis is that point in the course of the disease at which the patient is on the verge of either recovering or dying. No such decisive resolution is evident with respect to the problems of health and medical care."

It probably wasn't the best tactic for President Obama and the Progressives (what an awesome name for a psychedelic funk band that would be) to frame health care as being "in crisis," since that introduced an element of panic and hysteria into the proceedings, but in America no one will listen to your issue unless it's a "crisis." Everything is in crisis all the time--the economic crisis, the drug crisis, the education crisis, our cities in crisis, the global warming crisis, the illegal immigrant crisis...if there were that many crises, some of them would have resolved themselves already, or we'd all be dead.

2. "The average family will always have to pay its share of the cost one way or the other...If the system is financed through taxes on business, then people pay indirectly, either through higher prices for the goods and services businesses produce or through lower wages."

Some Democrats have been talking about the public option as a sort of magic bullet, something that will solve all or most of the health care problems in the US, which proves the old saying that loaning money to a Democrat is like leaving a Republican in the same room as an Argentine woman. What the public option will do, mainly, is shift the cost of insurance away from businesses towards the government. We'll still collectively have to foot the bill, and if we insure more poor people we'll--duh--have to pay more. This plan is expensive because--duh again--insuring an entire country is expensive. We can have a lot of uninsured people or spend a lot of money. No amount of yelling anti-semitic remarks at town hall meetings will change these two options.

3. "No country is as healthy as it could be; no country does as much for the sick as it is technically capable of doing."
Obama recently encouraged Facebook users to lazily participate in the debate by posting this as their status update: "No one should die because they cannot afford health care, and no one should go broke because they get sick." But the issue isn't someone dying from no health care, the question is how much health care we want to provide everyone. Should an 80-year-old alcoholic who smokes a pack a day get a $100,000 operation so he can live for one more year? Or should he die because he can't afford health care? How much of that bill would we as a community be willing to pay? "Rationing health care" has gotten a bad name, but we obviously have to ration health care--we don't have an unlimited supply of it, and we'd like to devote some money to non-health care related goals, like building tall buildings and getting shitfaced. So we have to decide how to ration our resources. But this doesn't fit on a Facebook status update.

4. "[Private insurance companies] have been fighting tenaciously in an effort to reserve an important role for themselves in whatever system is finally adopted, an effort which most knowledgeable political observers believe will succeed."This happened months ago. There's not that much hope for a meaningful health insurance reform anymore. Whoops.

5. "The greatest current potential for improving the health of the American people is to be found in what the do and don't do for themselves." Too bad everyone keeps to talk about economics in health care without talking about the health of our population. If we weren't so fucking fat, for instance, we wouldn't have so many health problems and everyone's premium's would be lower, but no politician will say that. Maybe if we didn't work so many hours or if we took more vacations we'd have fewer stress-related health issues. Maybe our life expectancy would start approaching Sweden's or Denmark's if we stopped shooting each other with guns. Too bad we decided to limit the "health care debate" to "health insurance" rather than looking at our health as a whole.

6. "Common sense tells us that if a household is offered a choice of either a hundred dollars in cash or a hundred dollars' worth of health care, it ought to prefer the cash." The Republicans, in response to what they saw as wasteful government spending, recently suggested spending government money to solve the problem. Their idea was to give poor people money they could only spend to buy health insurance. Sure, they didn't plan to give households enough money to actually buy health insurance, the poor might want to buy some food or education instead, and they might not have time while working two jobs to intelligently compare plans, and sure, the Republicans were basically handing money to private insurance companies--but the GOP is against Big Government! Kudos to the Republicans to staying true to their principles: not the "free market," because then they would be giving out straight money instead of subsidies, but to the idea that if an industry gives you a lot of money, you try to return the favor.

7. "If the past is a good guide to the future, the emphasis is likely to shift to getting legislation that appearsto serve great and noble purposes. Then, if the system in fact fails to live up to the expectations, the failure can be blamed on the administrators or on subsequent Congresses...or on the health professionals for sabotaging the programs." Health care reform has been fought over since World War I, and will continue to be fought over until World War II. Sometimes the alliances shift--early efforts to nationalize health care was opposed by labor unions--and sometimes the proposed solutions change--Fuchs was a fan of HMOs--but somehow, after every health care "crisis," health care goes back to sucking.

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