Thursday, July 23, 2009

Makin' me crazy...

Can't turn off my brain to sleep so here we go......

I don't love Obama's healthcare plan. Single payer, universal coverage, or "socialized medicine" is clearly clearly clearly the better option but Im not going to piss and whine and let perfect be the enemy of vast improvement because single payer is a non-starter and that's just reality. This is the difference between being dogmatically liberal and a pragmatist.

But that's not what keeps me awake nights, this does.

What makes my head wanna explode is that when conservatives oppose reform they aren't then offering a better option, or even a worse option. They aren't bothering to engage the issue period. So lets look at what conservatives are working for when they work against reform.


Will it cost a lot of money to change the current system? Why yes, yes it will. CBO estimates put the tab at something like $1.5 trillion and conservatives would like you to believe, or at least fear, that our grandchildren will have to eat dirt three times a week for 20 years to pay for that. Not so. Im not going to claim that it is revenue neutral but its hardly a budget buster in the way that things like wars of choice are or unfunded Medicare Drug plans, for instance.

So where's the dough? About 1/3 comes from savings from Medicare/Medicaid and the most of the rest comes from a modest tax increase on people who have money coming out of their asses, otherwise known as the top 1.5% of earners. But even after that increase those people will still be paying less in taxes overall than they were when Reagan (conservative Jesus) cut their taxes almost 30 years ago. To review... paying less, getting more.... reallllly struggling to see the suck in that.

On the other hand the conservative do-nothing approach supports a system that is already the most expensive in the world by a wide margin and is getting more costly by the day. The GOP supports a system that is doubling in cost every decade as of now and that's before most of the baby-boomers have really begun to stress the system further.. If your Congressman or Senator is against healthcare reform then they are choosing for you to pay 300-400% more for your healthcare when you retire in name of not taxing 1.5% of the population at a rate lower than it was 30 years ago. That's their deal.

Do that math. Sit down with your 401K statement and then extrapolate your current healthcare expenditures at a 300% increase and try to imagine how that's going to work out for you and yours. It doesn't work out at all but that's what conservatives stand for in this. They want you to pay a lot now, and then pay a helluva lot more later because it is easier for them politically.


Everytime I hear someone who is ostensibly educated call Obama a socialist it makes me wanna smack em in the fuckin' head with their college diploma, twice ,and then burn it because it clearly is doing them no good.

This is not socialized medicine. Im in favor of socialized medicine because its a much better idea. Im not getting my better idea but Im taking the next best thing. So what the hell is this?

Its the government incentivizing the market. Yes. It is a program that injects free market forces into a system and then letting that competition lower prices. Doesn't that sound kinda like a conservative idea? Why yes, yes it does. So why aren't they are board? Because they're too invested in the notion that taxes are always evil to get anything done and it blinds them to the possibility of common good, except of course when we're talking about bombing the shit out of some brown people cause that's a bargain at any price. So to be clear, taxes=bad. Out of control cost structures=good.

But you don't have to believe me. If you're afraid of socialized medicine do this little experiment.
Call your doctor and ask what he/she charges you for a specific procedure and then call your favorite hospital and do the same. Assuming they'll even tell you then take those figures and try to negotiate a better deal for yourself with another doctor or hospital. Ill wait....

Naw I wont wait either cause we both know what will happen. You will get nowhere. How can this be? In a non-Socialistic free market you should be able to shop around for the best price. There is no such thing as shopping around now for two reasons. First of all in many states insurance companies have effective monopolies and don't have to listen to your shit. Secondly the business of risk management is not about lowering *your* costs its about lowering *theirs* which means insurance companies are all about denying coverage when they can and charging as much as possible when they can't. A for-profit health system has no incentive to keep patient costs lower. Absent some redress it will never get any better than it is right now and will only get much much worse. This is what conservatives are in favor of.


When my dad was dying of cancer he couldn't get certain palliative medications because his insurance wouldn't pay for it. So instead he wretched and threw up his putrified stomach tissue till the day he died and those are among the last memories my mother has of him. Someone, not a doctor, made that choice for us because to have paid for his medication would have decreased the potential payout to their investors. When conservatives work against health care reform they are by default endorsing what my dad went through to preserve massive corporate profits. No way around that.

Now this is dicey territory I'll admit because there are horror stories in every system and one can't really know what's the exception and what's the rule. But really isn't that the point?

If our current system is so much better than the proposed alternative, or Europe , or Canada or anyplace else, why can we point to similar systemic failures? Shouldn't our delivery system be vastly better if the underlying principles are superior? Why yes, yes they should. But our delivery system isn't vastly better. It is marginally better in some instances and clearly worse in others but it costs more than twice as much and is bankrupting business and government, but even so conservatives would rather have us pay more for less because they lack the political courage to really address the issue. This is who they are. This is what they're in favor of.

If you support Obama's plan call your Senators and Congressman and tell them. If you don't support Obama's plan call your Senators and Congressman and ask them to offer a better idea.
But if you like having money and health you simply cannot sit this one out. Something has to happen.

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