Finally last night someone (inadvertently, and in the wrong place, and for all the wrong reasons) spoke the truth. Health care reform and the debate around it has all been a lie.
This massive political battle is not about improving the lives of the citizens of the United States, it’s about who’s going to control one of the largest industries in the world. And even if Congressman Joe Wilson was a jerk, he said what everyone has been feeling, that we are not talking about the real issues.
To get you all to agree or disagree with the current proposals for health care reform some really big lies are being told.
The first lie: All of this will have any effect on health care costs
In the U.S., health care costs are driven by lifestyle decisions and personal choices about longevity. Obesity, diabetes, heart disease, and lung cancer are the major drivers of health costs. All of these are the direct result of what we chose do every day.
Who in Washington is brave enough to say, “Put down the Big Mac, no more beer, stop smoking, go out for a walk?”
Promoting the idea that an industrial reform driven by the federal government will change this is a lie. We spend vast sums on health care late in life because of what we do early in life. Obama care will have no impact on that at all.
Health care costs are also driven by elder life extension decisions. The system spends vast sums on keeping our seniors alive for just a few more months. There is no gentle way to say this, but if you want to stop health care cost inflation you have to control geriatric care. To their credit the original Dem’s proposals included provisions to manage care at the end of life. To their shame they ripped it out and denied it ever existed after Sara Palin and her buds started screeching, oh, and after the AARP called.
Truth: This isn’t about health care costs, they will continue to spiral unless people change their daily habits or care is rationed.
Second Lie: All this will add needed regulation to an out of control insurance industry
The health care industry and the insurance industry that administers the payment of its expenses is the most heavily regulated industry on the face of the earth. The problem for those who want to control it is that it is regulated at the state level by insurance commissioners which really means by the New York and California Insurance Departments. So let’s be clear: This isn’t about “the people getting control of the system,” it’s about Washington taking over the system.
The objective of the “reform” bills written by congressional Democrats is the federal take over of the health care system. The correct term for this is “federalization”. Why can’t we just say that out loud and decide if that’s what we want?
“Single Payer” – “Public Option” these are disguise words, camouflage terms, meant to hide the real objectives of reform. If you argue that “Single Payer” doesn’t mean “Federalization”, then you are ignorant of how bureaucracies and institutions work. The fire storm of popular unrest this summer stemmed, in large part, from the fact that people figured this out and were good and grumpy about being lied to again, this time by a guy they trusted.
And to say that it is not the goal because it is not achieved right away is also a lie. The old story about how to boil a frog is so apt here.
And don’t get me wrong. I think a very strong argument can be made in favor of federalization, but lying about it is not going to get us to the right policy discussion.
Truth: The goal of the health care reform package is Federalization. Let’s just say it and have that debate.
The only two questions at stake in this discussion are…
- Do we want the federal government to take over the health care system?
- Will it work to reduce costs?
Everything else is smoke an mirrors.
The number of uninsured
The Dem’s and the MSM have been throwing around the 46 million uninsured number like it was true. The fact is that it contains 11 million aliens (who are illegal/legal/should be legal but are not, whatever…that’s another debate).
Obama says his program will not cover them. So is he’s saying his 46 million number is (yep you guessed it) a lie?
The 46 million also includes millions of others who have access to health care and insurance, and are covered, but are technically excluded from the count. Also in the 46 million are those who willfully chose, for religious and philosophical reasons not to engage in the system.
Oh, and my son, and all your college age kids who are covered under you polices are in that 46 million number as well. So are the prisoners in institutions that have health systems, and…you see what’s up here?
You can begin to understand why people were shouting at congressmen at town halls.
Access to insurance coverage is the same as access to health care
Granted I’m a finance wonk, but I’m still surprised how many times I hear people say “he couldn’t get treatment because he didn’t have coverage.”
If you are in a car accident on the Baltimore Beltway of I-95 the first thing that happens is the med-evac helicopter arrives and you are flow to the best crush trauma emergency care room in the world. Your survival rate is stunning. No one asks for your insurance card in the chopper, you simply are survived. In New York, hospitals are required to treat regardless of coverage. And foreigners routinely come to New York’s best hospitals and doctors and actually write checks for treatment without having insurance coverage.
The problem is these treatments are shockingly expensive – not that they are unavailable.
Access to care is nearly universal. The problem is the cost of medical care at both the treatment level and in the national aggregate, but that is not going to change miraculously because everyone has some form of universal insurance. Insurance doesn’t mean free, it means we share the cost for the unforeseen and unforeseeable.
Aside: The goal should not be that everyone gets to go to the doctor. The goal should be that no one has to go to the doctor.
In fact insurance is probably exacerbating the costs of care. Doctors and patents have no incentive to proved appropriate care, just massive care. (This is where the tort reform argument goes…)
Obama is not in favor of a government take over
One of the few things we know for certain about the pre-candidate Obama (he was carefully shielded from being involved in major policy issues as a young senator so he would be attack proof during a national campaign – at least according to PBS’ FrontLine) was his position on “single payer”. I watched the video. The White House says it was “out of context”. How can a quarter hour of a speech be out of context? Please, Mr. Obama just say this is about federalization and let us debate that point! Anything less is a lie.
The National Health Service in the UK and the Health Canada systems are better than the one in the U.S.
Huh? That’s why every one comes here for treatment, right? The U.S. shoulders the world’s medical research expenses, and then sends out the benefits of those breakthroughs to the world for free. What burden would the world’s nationalized services have to bear if the largest private sector health care system was shut down? Let’s at least figure out what that number is before we rush forward. And let’s also be real about scale. U.S. health care spending alone is greater than the entire GDP of the U.K. (I’m not going to embarrass Canada) so these comparisons are beyond meaningless.
And yes, people wait for months for treatment in the U.K. and Canada and, if they do not come here, they can die in the meantime. Some get better because they are not made worse by Western medicine. That issue of reduction in care is the real item and that needs to be debated.
If the goal is to improve morbidity and mortality by the reduction of invasive Western pharmaceutical based treatment methods, especially ones that cost a fortune, can we just say that? The truth is that there is vast rationing in the best national health care systems, (the worse systems like in Russia, well…they never seem to be brought up as examples of national health care systems, do they…) and they are very restrictive in the deployments of advanced treatments. To say otherwise is to lie.
The health care system will crumble under Obama care
The new idea promoted by the right, but recently picked up by the left in the New York Times is that the defeat of Obama care is a defeat of the Presidency.
The Times is championing this idea because by raising the stakes of passage they feel that it will become unthinkable to not pass a bill (any bill, just something, please…we must protect the hive!…)
The fact is, passage or non-passage will not mean the end of the world as we know it. The government has been in the health care business for decades, running VA hospitals and a vast military medical system. They have been in the insurance business via Medicare and Medicaid as well. These are big time industries in their own right, bigger than a lot of stuff (ahemm) north of the border.
The issues are really about the system we give the kids when we are gone. One that is on the leading edge of its industry or one that just gets by, borrowing from others, deep in debt, and doing an o.k. job at best.
Same with the Jimmy Carterization of Obama. Nothing disastrous, just not a sparkly as before.
Governments are efficient.
You could make a very strong case that the inefficiency in the current system is directly related to the current level of government involvement, not the other way around. Hospitals and doctors design their business systems around the requirements of medicare and medicaid. That’s not going so well is it? So more government is the answer?
I didn’t bring up the Post Office, Obama did.
Our health care system is perceived to be broken because we lead crappy lives and have removed all market place restrictions to the consumption of insanely expense treatments, primarily for the elderly.
Obama care is not the answer (gosh no!) But that doesn’t mean that a completely missing piece of health care delivery should not be provided by the government (gasp! Did he really say that?!)…and that piece should have a strong emphasis on primary and preventative care. By that I don’t mean more tests and pills. I mean lifestyle and healthy living. That’s were our problems begin; that and personal responsibility. So lets start by stopping the lies.
I’ve made the argument before that at one time police and fire departments were private and the local government system we now have now works much better, and we can do the same thing with our local public health care systems. They need to be run at the local level, without any federal involvement if they are ever going to get any better.
We seem to have a quick fix hope that the federal government can solve problems, when the fact is that it’s the local cops who know where crooks are going to strike, and the local fire fighters who know the layout of a building before the warehouse fire starts. Public provision of health care needs to follow this model not some uber all powerful department from D.C. that insists on its own expensive perpetuation, not on ending diet related childhood diabetes above 125th street.
The same should be true of local health care. There are innovative systems in the mid-west and in eastern rural areas that work very well, when not bullied by Medicare and Medicaid, and at least the cost would be felt closer to home and be voted on by local tax payers.
But that’s the point, right? The health care bill is not about health care, it’s about power and politics, and that’s a shame. All the points I raised above are about policy, but the sell of the two parties is about power phrases, poll tested positions, and the meanest kind of media thought manipulation. That alone should make you think twice about how much you want these people to control your lives, on either side of the isle.
In any event these are the issues we should be discussing. Yea, Congressman Joe Wilson was a jerk, but he was the only guy in that room last night speaking the truth.