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alexandraerinThis has been making the rounds for a while now, but I feel that liberal/progressive/decent human being/healthcare reform blogs should be blanketing the interwebs with this recording... this is the "private option", folks. Healthcare is rationed right now. The free market is a rationing tool, but right now it's being rationed artificially by the need to support the profits of layers of management and middle men. Right now, our collective ability to afford health care is being impacted by our ability to pay for panels of non-medical people who make life or death decisions for us*.
If the government operates a public insurance plan as a tax-supported non-profit entity, those same decisions will be made, and while money will come into it, it will not be with an eye towards maximizing profit, pleasing shareholders, filling corporate coffers, etc., which is how it's made now.
This isn't Underpants Gnome territory. HMOs and private insurers maximize their profits in two ways: by increasing the money they take in and by decreasing the amount of money they pay out. The free market will thus tend towards higher cost for less service. What are we going to do? Negotiate with them? Boycott? We have no real options which is why there is no real competition.
Thanks to Richard Nixon's odd combination of crippling paranoia and overweening arrogance, we have the tape where he listens to John Ehrlichman laying out the model of our current health care system: charge people money and deny them service. That's what we have now and as they say dans la belle tech industry, it's not a bug, it's a FEATURE. This was planned.
This was done to us, and we're all suffering for it.
Even if you've got health coverage now, even if you feel you can afford to pay for your own medical care, a healthy population directly benefits you.If your neighbors are healthier, you're healthier. If everybody's healthier, the nation is stronger. Right now we're dealing with diseases when they become outbreaks and dealing with chronic health problems when they become life-threatening.
This puts all of us in danger and it costs all of us money. Think about everybody who doesn't go to the doctor when they get flu symptoms because they can't afford to go if it's just the sniffles, think about everybody who has a preventable heart attack or stroke or seizure while operating a motor vehicle. Prevention is cheaper than cure, and safer for society.
Some Republicans like to inject the image of Ronald Reagan into this conversation and say that government is the problem, not the solution. Well, I'm willing to concede a point when they have one, and they do have one... because the government's fingerprints are all over this one. It's time to hold them accountable and make our government undo this heinous crime that was perpetrated against us. The late Senator Edward Kennedy fought this, he fought for public health care in the 70s, and he lost... on the rightwing blogs right now, there are people who are saying--in response to the push to pass healthcare reform in his name--that we can lay the creation of the HMO system and the current flaws at his feet.
Folks, there are an awful lot of sentences one can start with the words "Ted Kennedy was not a good ____________.", but this is not his doing... and even if it were, that shouldn't matter. We know the system doesn't work as it is. Seriously ill people who can't afford pain pills are being told in breathlessly horrified tones that if we went so far as even adding a public health plan then they'd be given pain pills and be told to go home and tough it out.
And a lot of people are buying it.
Way too many.
Canada's ongoing management problems do not flow inevitably and naturally from their decision to make sure that all the citizens of a modern, first world economy with a first class economy have access to doctors for preventive care. People point to the fact that the UK lags behind the US in cancer treatment like this is some damning blot on their system.
People, we are the United States of America.
It shouldn't be remarkable that Britain lags behind us in cancer treatment. It shouldn't be worth mentioning because they should be lagging behind us in everything. We should be leading the world instead of lagging behind it. The fact that this statistic exists and gets bandied about so much is itself a symptom of how sick our system is.
Do people think we're going to lose all our cutting-edge cancer research and experimental treatments and highly trained specialists if we change the layer of finance-arranging entities that stand between us and our doctors? No. All the stuff that makes us better on cancer is still going to be there.
Anyway, listen to the audio... and please post, link, share. This should be everywhere. This should be the answer to talk of rationing and talk about the power of the marketplace... I believe in the power of the marketplace, but once of its biggest powers is generating money, and that's what's being done now.
If food or shelter or clothing or water or any other basic human necessity were being controlled the way health care is right now, we'd be rioting in the streets...but because our need for health care is seen as sporadic and something we can avoid the need for if we're lucky or make the right decisions, we put up with the intolerable.
Share this audio. If you're active on any major progressive blogs, push it. If you engage with conservatives, push it... don't let it die until Richard Nixon is the voice and face of the "private option".
Let's do it to it, folks.
*Note to self: think of a snappy name for those panels of people who make life or death decisions for us... I bet if I could come up with an ominous-enough sounding sound byte for them, I can whip up all kinds of furor.
Edit to add, now that I'm more awake - before bed last night I went looking for any clip of the audio recording and posted what seemed like the best one. This is apparently actually footage from the Michael Moore film Sicko, which could form a natural "rebuttal" to it: "Oh my God you're quoting a Moore movie."... but the truth is the truth, it's not tarnished by association.
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no subject
on 2009-09-01 12:33 pm (UTC)Allow me
on 2009-09-01 04:59 pm (UTC)http://jupiterrhode.livejournal.com/67280.html
Re: Allow me
on 2009-09-01 08:16 pm (UTC)Re: Allow me
on 2009-09-01 11:21 pm (UTC)Re: Allow me
on 2009-09-02 02:13 am (UTC)Re: Allow me
on 2009-09-02 02:15 am (UTC)no subject
on 2009-09-01 02:07 pm (UTC)Maybe just "The REAL Death Panels"?
no subject
on 2009-09-01 02:18 pm (UTC)no subject
on 2009-09-01 07:19 pm (UTC)no subject
on 2009-09-01 04:48 pm (UTC)no subject
on 2009-09-01 06:01 pm (UTC)no subject
on 2009-09-02 02:29 am (UTC)Obama's promise that the government will pay for universal healthcare by pushing for more preventative healthcare options is nonsensical, as is the idea that any government run program will be more efficient than a market driven one.
Insurance, particularly health insurance, is one of the most regulated industries we have in this country, the idea that insurance companies are deliberately cheating you is more of a reflection of people's distrust of big companies then of reality.
Markets tend towards efficiency. How can you say that firms are trying to maximize profit and are operating wastefully by employing lots of unneeded "middlemen"? Those options are mutually exclusive. A firm trying to maximize profits is not the same as trying to cheat you and is not necessarily a worse option than having a government board trying to meet budget.
no subject
on 2009-09-02 02:44 am (UTC)A private organisation will be attempting to make profit. A government will be attempting to provide a service. Just because the first is more efficient doesn't mean that they will meet the second's goal more effectively.
Insurance doesn't need to be trying to cheat you to be unaffordable.
Finally, those options don't need to be mutually exclusive if you assume for corruption or deliberate manipulation of facts for ones profit(which I guess is corruption). But I wont go into that because I haven't seen concrete evidence for it, widescale.
no subject
on 2009-09-02 04:50 am (UTC)You are right in that they're doing a bad job of explaining what's going on, though.
The number one point though, is that there is no real competition. Without competition, there is no market drive toward efficiency.
Now, you might say that there are many insurance companies, so surely there's competition between them.
No, there really isn't. You might find some localized competition within large employers that can manage to attract a few companies to offer plans, and can establish an enrollment cycle that allows them to chose among set prices and service levels without worry of being singled out for any reason. The company represents a risk pool, and the insurance companies use that to distribute the costs more or less fairly. You cannot be dropped from service because they're bound by agreement to cover everyone at the company.
Not so for the individual market. An individual cannot pick up and enrollment catalog, choose a provider and service level and see a fixed price the way someone at a large employer can. They have to apply for a personal quote and effectively become a risk pool of one. You have to go through the same application process with each company, and each is essentially free to quote you whatever price they want.
This would be antithetical enough to fair competition, but that's only the beginning of the story. If you are currently covered and being treated for a condition, you're really stuck because even if a company would otherwise offer a better price or service they can refuse to cover your current needs or simply tack a higher premium onto your service to discourage you from switching. Again anticompetitive behavior.
But there's more on top of that- per the video at the top, the primary purpose of the company is not to ensure you get the best care possible for your money. It's to give as much of your money as possible to investors. So as long as you're healthy, they'll happily take your money, but as soon as you have a serious problem- one that they would incur a significant comparable cost to treat, you're out of luck. Remember that risk pool of one thing? Now you're really feeling it. If they can't find a reason to deny you outright or terminate your contract (even going as far as to search for minor, unrelated technical errors to provide and excuse) then they are free to inflate your premium to untenable levels to chase you away.
The entire market is anticompetitive from the consumer perspective. The only competition is that of attracting investors by providing the best profits- the market pushes them to maximize overhead and minimize service, not the other way around.
--Continued--
no subject
on 2009-09-02 04:51 am (UTC)Now market principles can actually apply.
Do note an interesting thing here- there's not government involvement in the actual provision of insurance yet, just in providing a fair market for service.
So what's the deal with the public option then?
Given the current state of affairs, it would take a long time for prices to come down to a reasonable range, because people are used to high prices or, at the low end would be subsidized, and there is still considerable pull from investors to maximize profits at the expense of service. But what if you introduced a non-profit option? One that didn't have investors to worry about, only providing care and remaining solvent? If it had to be self sustaining and operate on the same exchange as the other companies, it would create a significant point of competition; companies that shorted service of kept prices high would quickly lose business to it. Ones that matched or exceeded its value, on the other hand, would remain competitive. Now you've got market forces really doing their job.
What about such an option being unfairly advantaged in competition? Well you have to choose only one of two mutually exclusive positions to stand on - a non-profit, government based company is by its nature inefficient and the private market can easily out perform it. Or such a company would outperform any private solution and offer the best overall value for service.
Both can't be true, but either way, the consumers are the ultimate winner, which is the fundamental goal of the reform to begin with.
That overall system is at the core of all the major reform proposals, with some degree of variation. Wyden-Bennett, for example, does not include a public option, but it strongly establishes the exchange as immediately available to all people and transfers tax credits for coverage to individuals and away from employers. It also seeks to phase out medical entitlement programs in favor of care subsidies on the exchange and some wrap-around services.
Other proposals leave the employer based tax benefit in place and/or only make the exchange available to individuals and small employers, so more strongly need the public option to better dive competition, since they exclude a fair segment of the market.
There are other implementation details in the bills and logistics, but if more effort was made to explain that basic core, this issue would be a lot less contentious. It's about making the market work properly, not about taking over care in any way.
no subject
on 2009-09-02 04:42 pm (UTC)1. Point out to me where I used the word "cheat".
2. Apologize for your hyperbolic mischaracterization of my post, which you used as a technique to dismiss it out of hands.
3. See this comment deleted and never comment on my blog again.
Pick one and do it... I'm not going to fuss about which one you pick, but I'm not going to stand for this shit today.
"How can you say that firms are trying to maximize profit and are operating wastefully by employing lots of unneeded "middlemen"? Those options are mutually exclusive."
"How can you say that someone's following you and trying to kill you? That assassin stalking you would just get in his way!"
The firms are the middlemen I'm talking about. Under current economic conditions, it is necessary for most people to pool their money to share the risk of unpredictable health expenditures. A giant for-profit industry is not the best way to do this.
The regulations prevent "cheating". They don't prevent the insurance companies from providing less service for more money than is tenable, because we're in theory entering into agreements with them voluntarily. But the regulations also serve as a barrier to entry... today if a large enough group of citizens for it to be effective decided to cut out the middleman and pool their own money in a private insurance fund, they'd probably run afoul of the law for running an unlicensed insurance operation.
The market tends towards efficiency, but it doesn't tend towards fairness and it doesn't even tend towards the common good except in a shockingly Darwinian fashion... i.e., when it fails to serve the common good long enough, we have a period of upheaval and a correction happens. This could be society being crippled by a plague that could have been mitigated, this could be the economy plummeting past the point from which it can easily rebound due to lost productivity, medical bankruptcies, etc. This could be violent revolution.
If we're lucky, it could be people waking up to realize that the situation is untenable and intolerable and that it will correct itself if we don't correct it first.
Yes, the market tends towards efficiency, and right now the insurance companies are efficiently making money by efficiently denying services.
The insurance companies aren't cheating us. They're just not doing the job that we need them to do to survive as a society, and the market pressure doesn't exist to make them do it.
no subject
on 2009-09-02 04:42 pm (UTC)Has the White House completely detailed the reform that will be passed? No. Has Congress announced how it's going to handle the next death penalty case that comes before it? No. Has the Supreme Court said a word about who the next ambassador appointed will be? No. All is right in Constitutionland.
Because the President and the House Majority Leader haven't come out and said that the reform won't include a law that says that voter registration will be checked by hospitals and only Democrats will be given healthcare, this means that this is a possibility that's worthy of discussion? Really? The argument that the myths are the government's fault for not saying what they intend to do would be ludicrous even if it wasn't demonstrably false: the "death panels" shit was based on an actual concretely written-out bill! And the government (as in, the President and Democratic members of Congress) did say in so many words that no, this wasn't going to happen!
You can't blame the "death panel" myth on a lack of communication from the left. That's irresponsible fear-mongering from the right, plain and simple.
There is a grain of point in your post: the administration really does need to be more direct. President Obama's strategy of allowing Congress to come up with a bill to meet the broad goals of the reform in order to not be heavy-handed or autocratic is laudable, but since his most vocal opponents regard everything he does as a Socialist power grab it was too optimistic. Luckily for America, it appears that he's taking the September 15th deadline seriously and will take a more direct approach. I think he needs to speak to the American people directly, not in a series of town halls where only a few people hear his message but the entire country sees the protesters and hears the wild allegations and criticisms that are repeated by our supposedly "liberal media" (seriously, any time somebody with a syndicated column or a nationwide broadcasting platform complains about the lack of representation that conservative viewpoints get, they should lose a finger. I don't mean we should have a repressive government that mutilates journalists. I mean the universe itself should conspire to deprive them of a digit... there ought to be a tax on being that hypocritically and self-servingly obtuse.)
no subject
on 2009-09-03 02:32 am (UTC)no subject
on 2009-09-02 07:44 pm (UTC)Obama's promise that the government will pay for universal healthcare by pushing for more preventative healthcare options is nonsensical, as is the idea that any government run program will be more efficient than a market driven one.
This is false. I have been in the health care industry, and it does not run towards efficiency, it runs towards greed and profit. Sometimes this leads to efficiency, but with the health care it leads to double-digit increases in plan rates for the last 7 years.
The "efficiency" you speak of is brought about by cutting costs, generally speaking. In the health care industry, this is done by cutting benefits, cutting payouts, and cutting coverage. Companies INTENTIONALLY and DELIBERATELY stop covering people because they are "high risk", or if they simply cost the company too much. They have admitted as much, and have said they'd do it again.
As for the efficiency/middlemen argument: Explain to me how efficiency brings about peer review companies, who's sole job is to provide insurance companies with panels of doctors to review cases to prove that the case is not or should not be covered by insurance.
Less government is not always the answer. The Obama plan might not be the right answer either, but the health care industry is very much broken right now, and seriously so.
no subject
on 2009-09-02 02:50 am (UTC)It works, just not terribly well. Mostly, this is because little apparent effort is being made to address the issues in any meaningful fashion.
Sometimes it seems like the political parties purposefully leave the health care issues unsolved so that if they lose an election it will be too much work for another party to accomplish before they have a chance to blame it on the new party, so that they can be voted back in to continue doing nothing about the problem.
The problems are not insurmountable, we're just lazy. Assuming that ours is the necessary model to emulate is silly. Europe is where you want to be looking.
no subject
on 2009-09-02 04:51 pm (UTC)no subject
on 2009-09-03 12:07 am (UTC)I meant that the opposition/paranoia mongers should be looking at Europe instead of Canada.
By the way, that is an interesting spectrum of rebuttals to that one post above. Interesting in that they focused on very different parts of the original and all managed to make the same one or two points.
no subject
on 2009-09-03 02:09 am (UTC)My statements were intended as a general commentary addressing many arguments I have heard in the public sphere that I believe are the core of WHY many people are against a public healthcare option.
Furthermore I was hoping to illicite a response such as the one provided by pyrtolin, who can explain in more than emotional terms what is being discussed in government and why it is/is not a good idea.
My background is in economics, a subject I very much enjoy and a subject you mischaracterized and treated very poorly in your post, I say this only to explain why my comments may have come off as brusk.
I did not intend to offend you or anyone else, and If I did so I apologize.
no subject
on 2009-09-15 05:08 pm (UTC)Pyrtolin's response was based on publicly available information that your nonsensical emotionally overwrought post fueled not by any economic insight but by the nonsensical emotionally overwrought fearmongering against the public option would have us believe simply doesn't exist because no one's discussing it.
You've had almost two weeks to exercise one of the three options outlined above and you haven't. I don't care any longer, though.