Tuesday, August 11, 2009

I'm So Sick of the Health Care Debate that I Need to See My Doctor Before the Government Won't Allow Me To

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.


Doreen said...

Oh, I love you! Once again, you have put into words perfectly the way I feel. This whole health care debate has been buzzing around my head, and I've been trying to organize my thoughts on it, and you did it for me. I keep thinking, okay people, all you do is complain and talk about how your freedom is being attacked and whatnot, but what solution do YOU have? (not you STM, I mean a general you) Health care in this country is abysmal. I have an online friend whose brother's friend just nearly died because he is uninsured and nobody was providing proper care for him. Turns out he has cancer. He is going to be 21 tomorrow. It's infuriating. But yeah, let's go on fighting for our freedom. *eye roll* Can I just tell you again I love you? Thanks so much for this post! It just totally made my day. :o)

Scully said...

Amen! I am very tired of all the hate and the fear-mongering and the utterly disrespectful behavior couched in 'free speech' and 'constitutional rights'. I have to say, I have no problem with socialized medicine or the half-step of public insurance. I whole-heartedly recommend checking out the August 10th episode of The Daily Show, because it is funny and I don't know about you, but I can't spend too much time thinking about this before the rage sets in, and the laugh helps.

Desmama said...

Forty years ago when Social Security was the hot topic in Congress, Republicans called it creeping socialism. Now, they think it's the best thing they ever came up with.

Wonder what things will be said forty years from now?

Science Teacher Mommy said...

I just finished a book (Domina) about a fictionalized female doctor set in London and the US in the latter half of the 19th century.

Some of the storyline was a bit contrived (Puh-lease!) but I really liked other parts of it. It is amazing how far we have come in just over 100 years as far as medical advances go, particularly with women's health. There isn't time here to go into all the issues this book raised in my head, but there is one portion that is especially relevant.

Late in this woman's career, she decides to take on drug companies whose "medicines" are heavily laced with opium and alcohol, bottled under deplorable and humiliating circumstances. Labeling was still many years away and the doctor is infuriated by how ignorant people are about what they are taking into their bodies. She leads a big push to get reforms in place. What is she told? AMERICA IS A FREE COUNTRY; REQUIRING MANUFACTURERS TO LABEL THEIR BOTTLES IS A VIOLATION OF GUARANTEED CONSTITUIONAL RIGHTS. REQUIRING LABELING IS A LEVEL OF GOVERNMENT INTERVENTION THAT NOBODY WILL STAND FOR.

Since the industrial revolution, American politics has been vacillating between choosing what is best for the people and what is best for business. In the above case, labeling makes people freer by giving them informed choice. Did it probably cost the manufacturers some business when the laws were finally passed? No doubt. But it also gave them better business practices because of accountability to the public.

Government intervention has given us clean air and water; safe roads to drive on; schools for each person to attend; the chance to be college educated; security for our aging population; products that are safe for use; forests and beautiful places that are still pristine . . . . okay I will stop there. But I'm just saying that much of what is wonderful about modern life is a result of the government attempting to be accountable to PEOPLE and not to business.

Hah! I think I'm going to wear red today. ;)

chris w said...

I think this article : http://www.nytimes.com/2009/08/12/health/policy/12townhall.html
described in a good way the anger that has been building that is now erupting at the town hall meetings.

Just please keep in mind that people who don't think Obama's health care plan is the right one automatically just want the status quo to continue or don't care for those who can't afford health care.

There needs to be reform and it can be done without the government running the health care system.

As always, the answer to this problem lies somewhere in the middle and neither the Republicans OR the Democrats have the perfect answer.

Science Teacher Mommy said...

I think your last paragraph hits it dead on, Chris. But if that is the case, why won't the Republicans come to the table?

chris w said...

correction to my comment:
Please DON'T think people who don't agree with Obama's health care plan...


I think they are coming to the table in the only way they feel they will be heard.

Sherry said...

I have been wanting to write about this. And I probably still will. But you have said it so much better than I ever could have. Reform is needed. Let's settle down and get started.

Christie said...

After my recent heart hiccups, I realized what a blessing it is to have good healthcare coverage. And I believe that everyone should have access to affordable coverage. No one should have to declare bankruptcy because of medical expenses. In my mind government's purpose and power lies in its ability to collectively do for people what people cannot do individually for themsleves -- be it law enforcement, national defense or, yes, health care. Yes, it will be complex, yes there will be hurdels to mount, but YES, it can be done.

On similar note, I believe that both the government and the governed need to focus more on fiscal accountability. Wasting taxpayer money should be viewed as un-American, perhaps even treasonous. The probelm that I see is that Americans are becoming distrustful of how elected officials will spend (waste) their money. I think that much of the balking about healthcare has resulted because the Obama administration used up its political capital on the bailout, cash-for-clunkers, and other big ticket items.

Kimberly Bluestocking said...

Christie's comment about wasting money resonates with me. Our healthcare system is broken and needs serious reworking, but the cynic in me assumes that Congress (led by either party) will just churn out an unwieldy alternative or a band-aid that does little good. Looks like we may get the latter. Sigh.