I'm sick of it. You're sick of it. I have posted here before about it. I probably have little to say that is original, but after the latest round of Facebook postings (honestly, why did I think Facecrack was a good idea?) I just cannot stay quiet.
I appreciate that there are two sides to the public insurance debate. Which brings me to my first point. Trying to make this debate about socialism, or the intent of the founding fathers or Obama's secret plan for world dominion, or the government taking your doctor, or abortion, or anything other than public insurance is counter-productive when it comes to addressing a very real problem. Like it or not, nearly 50 million uninsured Americans is a problem. And not just your problem if you happen to be one of those unfortunate souls without insurance. People without access to quality, preventative medicine become a drain on society in almost every aspect--unplanned pregnancies, sick days at work, medical emergencies, lack of education about lifestyle choices . . . when we begin to talk COST, there are costs far beyond paying the doctor for an exam.
Which brings me to the second point. If public insurance is going to be offered, health care costs must be talked about. Here is a great example: most of the doctors in the practice I started with when we moved here have left. Various reasons. The clinic we go to only has one doctor, which we've never seen, two PA's and a bunch of nurses. I don't mind having not seen the doctor. All of our visits have been for shots and basic things like rashes, ear infections, etc. No specialist stuff. What I do mind, very much, is that there is no way for my clinic to bill my insurance at a lower rate, even if we don't see a doctor. My insurance company has NO CODE for it. They pay more, and that means I pay more because of my "patient responsibility" portion. It makes no sense whatsoever to have to pay to see a doctor, when I don't. What a simple way my insurance company can begin to control costs! For a detailed study of this debacle, check out this article. It generated a huge buzz in hospitals all over the country earlier this summer.
My third point is about insurance companies which are seriously concerned about going out of business. Government programs generally do have unintended consequences, but I just don't see this one happening. Nearly TEN percent of the American population is uninsured. This looks like a market share that is substantial enough to bear looking at (with a public option), but small enough not to harm the other companies, who have proven over the last several decades that they want nothing to do with that portion of the population anyway.
But when it comes right down to it, the debate must be about how this program will be paid for. I think this is, in large part, where the outcry at the town hall meetings has been about. Taxes. Unfortunately their legitimate argument which needs a lot of reasonable discussion, is being drowned in a sea of angry voices whose very assertion of free speech and constitutional rights is breaking down the democratic process and the right of others to peaceably assemble.
I understand the Obama administration's initial desire to push through this legislation from a political standpoint, but I also think that if these town hall meetings are allowed to progress, uninterrupted, with a reasonable flow of discussion from health care workers; experts from other countries using a public insurance option; public opinion from both side and the middle; economists; and policy makers then a compromise might emerge that will give any American who wants it access to health care.
Did the founding fathers envision a time when the government would hold a large stake in major corporations and banks? Probably not. And yes, in a lot of way, they would have wanted nothing to do with it. However, I don't think they envisioned a time either when huge corporations with enormous wealth would buy influence in congress to a degree that bills passed would make profits for a few the ultimate outcome of the American dream. Mostly, the founding fathers envisioned a government that would grow and change with the people. That was general enough it could apply to any reasonably educated people in any time period, but specific enough that the framework wouldn't collapse at the first test.
And my last point is also about money, though taking things in a direction that I haven't heard addressed very well anywhere else. The elephant in the room in this whole discussion of debt and taxes and government responsibility is The Iraq/Afghani War.
The appropriations since 2003 (just six years) given by Congress approach 1 trillion dollars. It is costing us nearly 2 billion a month to keep our troops in the Middle East. What do we have to show for this deployment? Thousands of dead Americans. Tens of thousands of dead in the Middle East. A tarnished American image throughout the entire world--both free and oppressed. A never-ending argument about whether or not we are actually "safer" because of said invasions. According to a congressional budget office report given two years ago, the costs of the long term finish up and pull out in the middle east (2017 projected) would top 2 1/2 trillion, though some experts set that number at 10 trillion. Another recent study posited another 300 billion to 700 billion in the long run in terms of health care costs for Iraqi war veterans, which doesn't include the more difficult to measure costs to families, sanity and productivity.
Will a public health insurance plan be costly? Yes, especially initially, with the long term benefits taking at least a generation to become realized. But I think a lot of those same people screaming at the top of their lungs in town hall meetings, are the same ones who led the charge into the Middle East in the name of . . . I don't know. Freedom? Revenge? Punishment? Defense of their Homeland? You have to ask yourself, if we are going to be a trillion in debt, what are we going to get for it? All of the above mentioned negatives of going blind into a war on the word of a few men, or a health care system that actually IS first rate? (A bipartisan congressional committee recently ranked the US 19th out of 19 studied developed nations for overall health care outcomes.)
Maybe the answer is neither. Cut our losses in both the middle east and with health care and concentrate on job creation to turn around the economy. Of course, small business are the best way to create jobs; but it is hard to take the chance to start a small business when it means losing your health care, or paying a monthly premium nearly as high as your mortgage.
Until the health care mess is approached on some level, there will be no economic turn around.