Friday, September 25, 2009

Swigging Robitussin on the Pirate Ship

Our school district considers the county fair a local holiday, and so today there is no school. Many of the teachers and students will see each other on the fair grounds today, but I will be home with my bottle of Robitussin, finishing this memoir by Howard Zinn and chasing each chapter with some tea.

My plan a week ago had been to attend a meeting in Los Lunas, up near Albuquerque, of the New Mexico Advisory Council on Arts Education, to which I am being appointed thanks to some anonymous recommendation. Instead, I'm having a little R&R: Robitussin and Rest.

How oddly right that I would be home sick on the very day the Senate Finance Committee is having a showdown and vote over the "public option," the creation of a non-profit insurance company to compete in a regulated marketplace with private insurance companies. This is something I fully support, only because my country does not appear to be emotionally or intellectually capable of endorsing a national health care system.

A friend of mine from my fanzine days, long ago, is an American living in Britain. Her name is Avedon Carol and her blog is almost every bit as good as her articles and letters in those archaic fanzines of a bygone era. She recently needed a very serious operation, and she has described in detail the care she received up to the procedure and during her recuperation. There was never a bill.

One of the saddest things about the state of my country is that the very people who very much need and deserve a well-funded and managed national health care system, something we really can achieve if we would only summon the will, are vulnerable to the most ridiculous and easily-debunked lies about health care and the alleged evils of a single-payer, nationalized system. Politicians and professional political organizers simply put on the Wagner music and start talking about the Soviet Union and Americans balk. Over and over again, enough people fall for this that health reform dies.

Consider how long it took just to get Medicare, and remember there are still politicians who boost their popularity by talking it down. There are politicians who would, today, vote to get rid of Medicare and leave retirees out in the cold. They believe, quite honestly, that if you cannot afford something you need with your own cash, you don't deserve it -- even if you'll die without it. Beneath the surface, that is a persuasive view here in our country.

And even now, with people denying themselves care because of money, with people dying because their for-profit insurance companies refuse to cover them when they get sick, with insurance executives almost forced to allow people to die because of Wall Street's expectations, all too many of "the people" are willing to believe that getting medical service from their own government is a slide into Stalinism.

Stupid. Stupid. Stupid.

Single-payer is not only off the table, it's not even in the house. For a while we have had this notion of a non-profit entity that would sell insurance premiums in competition with the profiteers, as a civilizing influence on the pirates. Weak, but we'll take it. Except maybe we won't. The insurance companies, their lobbyists, and the politicians whose tenure has been underwritten by the for-profit medical industry, have managed to scare off Congressional support for that as well.

And so today the public option might not make it out of the Finance Committee; and yet the individual mandate, the legal requirement that people buy insurance, is very much on. The pirates have won. We always let them win.

Have a swig of yer Robitussin, me hearties, and get back to those oars! If we be content to stay on this ship, we deserve what we get. Now get back to yer seats and row, ye miserable slaves. Row! Where's me lash? ROW!


Gary Farber said...

Embedded video of Avedon talking about health care, etc., here.

Kelly said...

Sorry you're under the weather and hope you feel better soon.

Pam said...

Sorry you're under the weather, Alg! Hope you feel better soon!

As for the single-payer national health-care option, I don't think it's even doable in this a country this size. I think we're a looooong way from seriously considering that.

People in countries that have national health care are of varied opinions as to how well they work.

I watched a series of pros and cons of the various countries who have national health care. Some of them were running out of money as the populations grow.

Bottom line was that there are pros and cons to national health care. It's not a panacea for what ails our own flawed system.

There are many good options and ideas out there, as I've said before. There should be a way to incorporate the best of the best, and yes, including a public option, and weave a workable fix for our country.

One size fits all is not the answer in a country this size.

Sending healing thoughts your way! :)

Algernon said...

Pammy, fire departments aren't perfect either -- but we have them.

It's something we can do. It's something we need. It is a matter of funding. We don't say to ourselves, "Gee, there really is no way to wage two major land wars simultaneously while we cut revenue." But that's just what we did for a decade. We always have money to invade countries and kill human beings, and never seem to have any money to take care of people.

I don't buy weak denials like "we're too big." Show me a CBO report that says the United States is too big for a central health care system. And if it is, then we divide the work into three or four regional health plans.

The point is: this must be done. We are Americans, and once we accept that a thing must be done, we sit down and figure out how to do it. That's what industrialists have done. That's what the labor movement used to do. That's what the civil rights movement did.

It's not a matter of can't, Pam. It is a matter of won't.

Algernon said...

For further looks at how this can be done, please look up H.R. 676 and S. 703 (two different bills with different approaches to establishing and funding cost-effective single-payer health care).

The point I keep forgetting to make because I think it ought to go without saying is that WE ALREADY HAVE A HEALTH CARE SYSTEM WE CAN'T AFFORD. One of the virtues of a good single-payer system, besides that whole tiresome humanitarian business, is that we can **save** money by doing it.

If you don't care about the human lives, surely you can't object to saving a buck?

quid said...

Robitussin and the Senate Finance Committee. A day in hell, I say.

Not to worry if we're too big. A few more subsidies and B of A will be bigger than the whole US. And we'll never let them fail. :)


Pam said...

Actually, Alg, I went and read them. Most of what the bills contain sound great, almost utopian.

The problem is it will never fly, will never pass.

Reading the bill it sounds like each American can have cradle to grave healthcare for all the hits that might come his/her way. I'm not talking cosmetic here. I'm talking the routine or big stuff that one can encounter in a lifetime.

I can even begin to see how that can be financed ( and I did read the overview of how they plan to do so ).

Once again, it lies within all the little details that I could see were trip-ups or questionable as I read the bills.

Like I said, it sounds like a wonderful utopian dream that I would love to see for America. I can also say I don't see this passing in my lifetime.

In the summaries of all the national healh care of most of the other countries there were major stumbling blocks along the way. Also, many of them are on the brink of going broke as well as a host of other issues.

I still say there is a way to 'include' a public plan in any well-thought-out bill can can come to terms on ( assuming that's even possible in our Congress). I see that as the more likely to pass at some point than the utopian vision.

I'm afraid I don't get your 'saving money' point. No matter what we do, and we DO need to do something, it's going to cost every American. How much and how to spread the cost are part of the tricky details.

Algernon said...

Pam - the devil is always in the details, but the point always come down to a decision. No one is suggesting the outcome will be perfect or "utopian" (the whole meaning of "utopia" is something unobtainable); what is clear is that we can do better.

The rest is a matter of political will.

Integrated schools -- that hasn't worked out perfectly, and many good-willed people argued that it was impractical, a "utopian" idea that would do more than good. But we had to do it, and we did do it.

And so it was with many things.

Social progress is always frightening. Change is always frightening. It never comes easy.

But justice and dignity require it.

As for saving money, this is the reality: our costs are out of control. Controlling the costs saves money and provides more service for what we do spend. No more uninsured people. No more people having to use the E.R. as a clinic (which is a huge driver of costs). No more hiking premiums to meet Wall Street projections.

Yes, it costs every American -- but the point you keep neglecting is that it is already costing every American more than it should, and we are not getting the service. Your money is being wasted right now, Pam. You should be furious about that and demanding public health reform, based on your own comments here.

I think of you, after all, as a conservative. And the intelligent conservatives I know understand that when they pay for something, they deserve the best and most efficient service they can get. The profiteers are ripping you off and they have been ripping you off for a while.

Therefore, even if other people's suffering is of no concern to you whatsoever, on sheer cost-effectiveness the real conservative has got to side on competition and some new consumer protections for your own insurance dollar.

Kelly said...

No one ever mentions defensive medicine costs. I have personally known doctors who have had to give up areas of their practice they enjoyed (specifically obstetrics) due to the high cost of malpractice insurance.

You know that costs are bound to be adjusted throughout the healthcare system (doctors, insurers, hospitals) to reflect the billions wasted each year on frivolous lawsuits. (keyword: frivolous. I do know there are legitimate medical lawsuits.)

Addressing the American Trial Lawyers Assoc. would be one way to start cutting costs.

Pam said...

And, as I've heard more than one expert on the subject say, if we intend to pass any of these proposals and if we truly intend to solve the issue, we first have to cut the current cost of health care.

No new plan will be sustainable until we reign in the costs.

Perhaps that should be where we start.

Algernon said...

Tort reform? Sure. Let's do it. Make malpractice more affordable? Great. I'm all for it.

Be aware that some of those who are trying to delay or derail meaningful reform are exaggerating the extent to which malpractice lawsuits are driving costs. The CBO indicates it is not a major driver of health costs.

Still, as a matter of justice, I'm all for it -- along with everything else required for meaningful health reform.

Pam, your last comment is vague. Who is going to rein (not reign -- that's a different word) in the cost "first" and how? The costs aren't under control; that's why regulation is required. Did we wait until homicide rates went down before passing a law against murder?

Pam said...

Yes, Alg, I realize I used the wrong rein. Also, you're analogy of murder to health care doesn't compute for me.

Going back to your costs and regulations, all that is vague, also. You want to slap a host of onerous regulation and/or penalties on private or for-profit enterprises, etc. and force everyone under the thumb of the government.

There is just no feasible, doable way that the government can or will provide cradle to grave health care for every American.

No one has proven that costs can be controlled under these proposals. No one can even agree on WHAT the costs will be. All sorts of figures are tossed out.

Let's say one of these proposals were to pass. What would the health care look like? What would we really be getting? What kind of doctors would we find, even if we could find enough? How much is it REALLY going to cost each of us and what will we will be getting for that cost?

You sneer at tort reform, but I know, personally, a number of doctors who left certain specialities due to the increasing cost of malpractice insurance. It's shouldn't break the backs of the doctors. BAD doctors should be punished. The AMA should do more police its members.

GOOD doctors shouldn't be forced out of specialities, however, because ( I speak, specifically, of obs)some people want to sue if they don't get perfect babies.

You know as well as I do that we live in a litigious society.

Sure, tort reform is one area that needs to be reined in, as does hospital costs, paper costs, jacked-up costs, drug costs, etc.

WAYS to do this needs to be put into place before jumping into the great unknown.

Why should we pass some utopian bill and then, and only then, attend to the details? Most of us don't operate that way in our own lives.

The comment about my being a conservative is only partially true. I'm more conservative than you, but much less so than my siblings. On some issues I'm quite liberal or progressive, if you will. As I've grown older I've become more conservative in some areas and less is others.

I care very much about my fellow man. I care about the suffering of others as well as my dwindling pocketbook.

My daughter is still unemployed and soon her COBRA will run out. My grandsons have serious and costly medical issues. I can't pay for them. She needs some kind of insurance for them, they are kids.

There needs to be some kind of affordable option for her to buy to cover her kids. There's not. She has to find a job that comes with benefits to get the boys covered. It's a catch-22.

so, yeah, we need reform. I'm just not sold on the single payer option you're talking about. Hey, I'm on a govt. plan, I'm a new Medicare recipiant. My grandsons can't even jump through all the hoops to get on one. I'd basically have to take away the roof over their heads to get them under that umbrella.

Algernon said...

Pammy, detailed information is out there for anyone interested enough to examine it. I'm an overworked schoolteacher with an internet connection and I have found volumes of information, in more detail than I cared to know, about what is driving health care costs, long-term trends, and detailed estimates based on various strategies, the alarming demographic changes taking place, and projected GDP into my son's early adulthood.

The regulations under consideration are no doubt "onerous" to large, profitable corporations that are used to having free rein (we like that word!) in a largely unregulated marketplace. The problem is, people are DYING for their freedom. Others are going bankrupt for their freedom. It is an enormous and expensive social injustice, sitting there like a gigantic boulder. Now that we propose some simple consumer protections and the tycoon cries, "No! This is not the American way! You can't impose rules on us! This will kill us." The thing is, it really won't. They don't want real market competition, Pammy. They want what they have had for a generation: a largely unregulated oligopoly.

You like medicare. Extending that to every American citizen is simply a matter of committing the funds (which we do have). You should not HAVE to take the roof away to extend it to them -- America can provide it when it has the political will to say, Hey, we can extend this to every citizen, we should do it.

But even you aren't ready to make that step. And so progress waits until good people are ready. That's how it has always been and is now.

But don't tell me it can't be done, Pammy, because it's sitting there waiting to be done.

Pam said...

One thing I am certain of, Alg, is that I would/will be ready to take any step that insures medical coverage for my grandsons.

They are children who had did nothing to be born with the issues they deal with. They deserve health care.

I don't know how we make that happen. I get what you're saying; I see other potentially viable options. I don't have the answer. I honestly don't know what's the best way to achieve what we all want.