"The less care they give them, the more money they make."

[alexandraerin]

This 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.

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*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.

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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.

Comments

[pyrtolin.livejournal.com]

Now, take the exchange systems being proposed. They function just like that employer enrollment system and with all providers, except they apply to all people, not just the folks at one company. Now you've essentially got a big book where each provider lists its plans and the price for them. And it operates just like an employer based program- price per plan, not per person; a regular enrollment cycle; existing conditions must be covered; and no one can be dropped, denied service, or have an individually inflated premium.

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.