Healthcare 2020
2009 was an eventful year in developments leading up to our current state of political and economic division and inequality. Barak Obama was inaugurated as President of the United States, an event which set in motion significant events in the realm of opposition politics. The brothers Koch called an emergency meeting of their cabal of ultra-rich, radical-right, reactionary, racist business comrades including Philip Anschutz, the Colorado oil magnate, and Sheldon Adelson, the guy who owns Las Vegas. These folks were terrified and appalled that a black Democrat held the highest seat in the U.S. government. They immediately set about increasing efforts they started 20 years earlier to fund opposition action groups under the guise of “charitable foundations” and other clandestine funding mechanisms (enabled by the infamous Citizens United v. FEC) that purchased university professorships in economics, law, and sciences, and paid for the elections of several U.S. Senators and Representatives.
2009 was also the year that Fox News abandoned all pretense of being a legitimate news organization and became a blatant propaganda arm of the Republican Party. Together with Rush Limpdick and his Excessive and Incessant Bullshit (EIB) Network, along with other right-wing outlets, both local and national, and the obstructionist opposition in the Congress, they set out to dismantle all things Obama. The hot topic at the time was the Patient Protection and Affordable Care Act (PPACA). It was in this atmosphere that I shared some thoughts about the debate. Most of it appears below. I have edited out some commentary about what was going on with me work-wise, and about the heat wave going on at the time in the Pacific Northwest (*). Eleven years later, it is sad to say that most of what I wrote is still relevant. Pandemic aside, at this time there are still too many people in this country who cannot afford to go to the doctor for preventative care, and we still spend more on health care per capita than almost any wealthy industrialized country. We are throwing good money after bad in order to perpetuate a system that helps too few and costs too much. https://www.pgpf.org/blog/2019/07/how-does-the-us-healthcare-system-compare-to-other-countries
I envision an old neo-con on a
mountaintop with a long beard, sunken eyes, emaciated, and with excessively
long fingernails that curl on the ends.
This old fart has an original thought about every ten years, sends it
off the mountain to the land of talk radio where Rush, Sean, Bill Bennett,
Ingraham and the ditto heads ride it and whip it until it turns to dust. It is reincarnated periodically. Sometimes it is spiced up by being delivered
by one in the long succession of blond bitches (Ann Coulter, Monica Crowley,
etc.) who went to college and learned that they could make bank in the
conservative political entertainment industry that operates with the knowledge
that blather, bombast, and bullshit out sells straight reporting. Hence the private jets, etc.; just like John
Travolta and George Clooney….
….When I
got back to Seattle, I had a day or so of work to do for the store in Kent and
quickly reverted to my old routine of listening to Public Radio on the way to
the shop in the morning. The topic of the NPR discussion that morning was the
health care reform measures currently before Congress. By the time I was
finished hearing the opponents’ platitudinous sound bite arguments, and the
proponents’ ineffectual attempts to counter them, I was so pissed I could have
spit nails. I was too disturbed to even be driving, let alone driving in Puget
Sound area morning traffic. I immediately thought I should write something
about it—right after I shot the asshole who just passed me on the right and
then cut left in front of me. But several attempts at composition yielded no
fruit. Each time I started to formulate some coherent ideas, I had a recurrence
of the flushed-face, vein-in-the-neck-popping, spittle-spewing, anger that
overcame me that first morning. I simply could not make a cogent argument. This
went on for well over a week. I discussed this frustration during a family
gathering the other night and someone astutely noted that this sounded like
just the sort of thing one should blog about. It was in fact the essence of
blogging. I thought, “Hmm”, and then, “Screw it, here goes.”
I’m still too pissed to make any attempt at rational argument. This puts me on equal footing with the planted shouters who have been showing up at the “town meetings”. These are not “town” at all, but rather nationally broadcast forums being used for organized dissent. I have no problem with organized dissent, but do not try to call it something else. It is like the old ploy of waging all-out war while engaging in peace talks. This is one of the most effective tools of war; kick their asses before they know they are in a fight. Righties use the tactic with finesse. Any time there is a suggestion that working people might have a different agenda than the privileged; someone is accused of “trying to create class warfare.” News flash! It is a war, has been for decades, and working and middle-class people are getting whooped while they are in denial. The opposition deftly uses emotionally driven arguments to counter reason. This is a remarkable skill. But why bother? Emotion wins out over reason every time, so I will try to keep reason to a minimum despite constant temptation from facts and logic.
Should the government even be involved in healthcare?
You bet. The government, often with the approval and encouragement of the right, is involved in protecting us from everything under the sun. The government has taken it upon itself to protect us from communists, Corvairs, mythical WMDs, pot smokers, prostitutes, profanity, monopolies, gay marriage, pesticides, misleading advertising, hydrogenated oil, sodomy, and the list goes on. Why should it not then protect us from cancer, heart disease, diabetes, arthritis, and malaria? Oops! It already does that by subsidizing spraying programs and draining swamps. If you think there is any aspect of your life that is not already regulated, subsidized, or otherwise affected by the government, you are living in a fantasy. You want to live in a society without government involvement? I will bet most likely you don’t, not really.
[The subject of subsidy is a topic in itself. If the government spends one penny to subsidize anything from agriculture to space exploration (it does), it should subsidize medical research (it does). If it spends one penny of taxpayer money to subsidize that research, the fruits of the research should be available to every person who ever paid a penny of tax. I say, “No taxation without free bowel resection!”]
Will the proposed reform somehow limit my freedom to choose healthcare options?
I don’t really know, but I doubt it, and if it does, I really don’t care. Money talks. If I can afford choice, I am damned sure going to get some. Meanwhile, people who do not have insurance can’t even get into a hospital unless they go to the emergency room. They have zero choice. Now this is the place where I should introduce statistics, expert testimony, etc. Sorry, heard ‘em all, don’t care, you ain’t changing my mind. Sound familiar?
Will the proposed reform create a huge expensive bureaucracy?
Probably. So what? A bloated bureaucracy is what the government already is. There is no bigger bureaucracy in the world than the U.S. military and we are all in favor of that. They are protecting us from a whole bunch of stuff. This bill may cost (How do the right-wing radio dipshits put it?), a thousand-billion dollars over ten years. (Only a liberal would mask the dire reality and trivialize the figure to a mere one trillion.) That is only 200 billion more than we just gave to the bloated bureaucratic banking industry over what—a millisecond? Actually, we would just be replacing a private bureaucracy we already fund through subsidy but without oversight. Maybe if there are enough government jobs out there, we all might get one. I hear they come with insurance.
What about the fact that xyz% of Americans are happy with their current coverage?
Hooray! This presupposes that they have coverage to begin with, and I congratulate them. Aren’t they the lucky ducks? “I have mine and I do not care about yours.” Now that is the kind of thinking a strong society is built on. At the internet urging of a sibling, I was recently directed to a website: Defend Your Health Care.croc.** Well, I guess if I had some that was worth a shit and that I could afford, I would defend the hell out of it. The site has some great examples of fear mongering and carefully crafted rhetoric. To counter the argument that covering preventative care will help contain increasing health care costs, the website has this to say. “…., virtually all studies show that prevention saves lives but not money.” Well hell, that is disappointing—wouldn’t want to save too many lives.
It goes on to say, “Most people who take cholesterol lowering drugs or get mammograms wouldn’t get sick anyway.” Isn’t that kind of the point? Just saying.
For a few more laughs, check out the website poll:
Who do you think will be hurt most by the Obama health care plan?
1. Small business.
2. Families.
3. The elderly.
4. Veterans.
5. Children.
6. Terminally disabled.
I’m still too pissed to make any attempt at rational argument. This puts me on equal footing with the planted shouters who have been showing up at the “town meetings”. These are not “town” at all, but rather nationally broadcast forums being used for organized dissent. I have no problem with organized dissent, but do not try to call it something else. It is like the old ploy of waging all-out war while engaging in peace talks. This is one of the most effective tools of war; kick their asses before they know they are in a fight. Righties use the tactic with finesse. Any time there is a suggestion that working people might have a different agenda than the privileged; someone is accused of “trying to create class warfare.” News flash! It is a war, has been for decades, and working and middle-class people are getting whooped while they are in denial. The opposition deftly uses emotionally driven arguments to counter reason. This is a remarkable skill. But why bother? Emotion wins out over reason every time, so I will try to keep reason to a minimum despite constant temptation from facts and logic.
Should the government even be involved in healthcare?
You bet. The government, often with the approval and encouragement of the right, is involved in protecting us from everything under the sun. The government has taken it upon itself to protect us from communists, Corvairs, mythical WMDs, pot smokers, prostitutes, profanity, monopolies, gay marriage, pesticides, misleading advertising, hydrogenated oil, sodomy, and the list goes on. Why should it not then protect us from cancer, heart disease, diabetes, arthritis, and malaria? Oops! It already does that by subsidizing spraying programs and draining swamps. If you think there is any aspect of your life that is not already regulated, subsidized, or otherwise affected by the government, you are living in a fantasy. You want to live in a society without government involvement? I will bet most likely you don’t, not really.
[The subject of subsidy is a topic in itself. If the government spends one penny to subsidize anything from agriculture to space exploration (it does), it should subsidize medical research (it does). If it spends one penny of taxpayer money to subsidize that research, the fruits of the research should be available to every person who ever paid a penny of tax. I say, “No taxation without free bowel resection!”]
Will the proposed reform somehow limit my freedom to choose healthcare options?
I don’t really know, but I doubt it, and if it does, I really don’t care. Money talks. If I can afford choice, I am damned sure going to get some. Meanwhile, people who do not have insurance can’t even get into a hospital unless they go to the emergency room. They have zero choice. Now this is the place where I should introduce statistics, expert testimony, etc. Sorry, heard ‘em all, don’t care, you ain’t changing my mind. Sound familiar?
Will the proposed reform create a huge expensive bureaucracy?
Probably. So what? A bloated bureaucracy is what the government already is. There is no bigger bureaucracy in the world than the U.S. military and we are all in favor of that. They are protecting us from a whole bunch of stuff. This bill may cost (How do the right-wing radio dipshits put it?), a thousand-billion dollars over ten years. (Only a liberal would mask the dire reality and trivialize the figure to a mere one trillion.) That is only 200 billion more than we just gave to the bloated bureaucratic banking industry over what—a millisecond? Actually, we would just be replacing a private bureaucracy we already fund through subsidy but without oversight. Maybe if there are enough government jobs out there, we all might get one. I hear they come with insurance.
What about the fact that xyz% of Americans are happy with their current coverage?
Hooray! This presupposes that they have coverage to begin with, and I congratulate them. Aren’t they the lucky ducks? “I have mine and I do not care about yours.” Now that is the kind of thinking a strong society is built on. At the internet urging of a sibling, I was recently directed to a website: Defend Your Health Care.croc.** Well, I guess if I had some that was worth a shit and that I could afford, I would defend the hell out of it. The site has some great examples of fear mongering and carefully crafted rhetoric. To counter the argument that covering preventative care will help contain increasing health care costs, the website has this to say. “…., virtually all studies show that prevention saves lives but not money.” Well hell, that is disappointing—wouldn’t want to save too many lives.
It goes on to say, “Most people who take cholesterol lowering drugs or get mammograms wouldn’t get sick anyway.” Isn’t that kind of the point? Just saying.
For a few more laughs, check out the website poll:
Who do you think will be hurt most by the Obama health care plan?
1. Small business.
2. Families.
3. The elderly.
4. Veterans.
5. Children.
6. Terminally disabled.
This is so obviously shaded; we don’t even need to change the question, just the answers:
Who do you think will be hurt most by the Obama health care plan?
1. Drug companies.
2. Drug company lobbyists.
3. Insurance companies.
4. Insurance company lobbyists.
5. Right wing commentators.
6. Fat assed Republican Senators.
Will there be some sort of panel or process for evaluating expenditures in end-of-life circumstances?
Absolutely not; but would it be so horrible if there was? Hey! We’re all laissez-faire survival of the fittest types, and let’s face it, skeleton Granny ain’t never gittin’ up, and if she does, she ain’t goin’ far and likely won’t know where she is when she gets there. And we are told every day that it’s all about the $$$$, and “hard choices,” and that kind of crap. If a grieving family needs some help while facing this extremely difficult situation, I would hope that counseling would be available. In fact, that’s all the bill does. It simply proposes to add counseling to the list of covered services. It doesn’t create any death squads or panels of liberal intelligencia (excuse the redundancy) to decide who lives and who dies. The notion of the “death panels” is a prime example of the opposition’s use of fear as a weapon. Plenty of fear can be generated around this topic because we well know that as our society ages; we will have to deal with this dilemma increasingly often. Right now it’s more comfortable to just ignore it and hope it goes away. Using it to make political capital is despicable. How about mandated living wills? At least then we would only be prolonging the existence of people who want it. I will bet there wouldn't be very many. Is that intrusive enough for you?
Should universal coverage even be a matter of debate in
this country? In this century?
Hell no! That’s what got me so riled in the first place. It was not the inane arguments or the imbeciles who were delivering them; they are old and tired. It was the very idea that we are still spending time and intellectual effort in arguing something that almost every other civilized country put to bed shortly after World War II. OOH! We don’t want any European style system in this country. Fine, have another style, but for the love of Pete, have something. If the legislation that comes out has flaws, fix them later. The problem now is that we don’t even have a base from which to begin repairs. The status quo is unacceptable, and in your heart, you know it.
Hell no! That’s what got me so riled in the first place. It was not the inane arguments or the imbeciles who were delivering them; they are old and tired. It was the very idea that we are still spending time and intellectual effort in arguing something that almost every other civilized country put to bed shortly after World War II. OOH! We don’t want any European style system in this country. Fine, have another style, but for the love of Pete, have something. If the legislation that comes out has flaws, fix them later. The problem now is that we don’t even have a base from which to begin repairs. The status quo is unacceptable, and in your heart, you know it.
Where
we are now (again, pandemic aside):
In my original diatribe, I swore not to let facts and reason interfere with emotional argument. I have calmed down some since then, and this stuff is just toocompelling and too supportive to pass up.
The PPACA
passed a Democratic controlled Congress on March 10, 2010. Republicans in both houses introduced bills
to repeal it the day after it was passed.
As of February 3, 2015, the House had 67 repeal votes. I do not know how many there have been since. Republicans led numerous attempts to defund
implementation; in 2017 the repeal and replace effort also failed. Trump’s first executive order screwed with
the bill by weakening the individual mandate.
He then reduced funding for resources to aid enrollment and reduced the
enrollment period by half. These actions
reduced the number of people the bill was helping. He then made a (false) public statement that
the exchanges were unstable, further undermining the law. There is presently a huge hue and cry from the right about the amount Congress spent on the impeachment attempt. How much have they spent trying to undermine an attempt to help people?
Meanwhile, in the U.S., healthcare spending as a percent of GDP is 16.9. The next highest is Switzerland at 12.2; the UK is 9.8. The per capita cost in the U.S. is almost twice the average of other wealthy developed countries. Due to inefficiency and administrative waste because of complexity and the waste involved in trying to deny coverage, our administrative cost per capita is $843.00. This is more than we spend on preventative and long-term care. Come on people! After all of this, you still cannot go to the doctor in this country unless you are stinking rich or you are employed by someone who is stinking rich, and you have a better job than most of us have. Making employers responsible for our health insurance inhibits their ability to be competitive on the world market, and competitive capitalism is supposedly what we are all about. Is it not?
Meanwhile, in the U.S., healthcare spending as a percent of GDP is 16.9. The next highest is Switzerland at 12.2; the UK is 9.8. The per capita cost in the U.S. is almost twice the average of other wealthy developed countries. Due to inefficiency and administrative waste because of complexity and the waste involved in trying to deny coverage, our administrative cost per capita is $843.00. This is more than we spend on preventative and long-term care. Come on people! After all of this, you still cannot go to the doctor in this country unless you are stinking rich or you are employed by someone who is stinking rich, and you have a better job than most of us have. Making employers responsible for our health insurance inhibits their ability to be competitive on the world market, and competitive capitalism is supposedly what we are all about. Is it not?
(*) I had to do a hydraulic repair on a front-end loader in Portland. It was 106ᵒ. It is never 106ᵒ in Portland.
**In 2009 there was a defendyourhelathcare.something website. I can’t find it now.
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