Posts Tagged ‘Health Care’

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Some Thoughts About Healthcare

September 6, 2009

A quick piece I wrote sometime last year, or so–all the more relevant right now.

I’m a fiscally conservative liberal. It sounds like a contradiction in terms, but I promise you, it isn’t. I’m certainly not a libertarian, and I do not propose that I fall anywhere in your neat little political spectrum graph you have embedded in your head. I believe in providing some basic necessities of life, such as healthcare, retirement security, and social safety nets through grouping our resources as a community. I believe that we can do so in a cost saving manner, while ensuring a quality of life that is greater than current conditions.

That is how I view the function of government. I see it as our collective ability to help each other, and ourselves, through working in concert on the most basic of needs. We needn’t create massive bureaucracies to do so, nor do we need to give up our individual rights. No one wishes to have a government that is oppressive, or one that takes too much, and provides too little. These are the ingredients to doing the opposite of the what was intended.

The free market is fine and dandy for many, many things. It has proven effective at controlling costs up to a point, and provided us with ingenuity and inventiveness unseen for the vast majority of human history. It seeks to fill needs not yet provided, and punish those who would attempt to become robber barons. But it doesn’t always work. We know this. It isn’t that it needs to be done away with, or massively overhauled, it doesn’t. It just needs common sense measures to ensure it’s proper functioning.

The best example of the free market’s imperfection can be found in the mills and factories of the early twentieth century. Men, women, and children forced to labor in squalid conditions, and made to live as slaves within a framework of freedom. As a people, we rejected this, and rightly so. We put in place regulations and guidelines to correct the abuse of a few on the many, and the system was saved from catastrophe.

We have these dilemmas on a smaller scale each generation. Today, we have a few that need to be addressed. The free market has attempted to provide inexpensive healthcare while regulations have been put in place to help those that the corporate structure cannot, or will not help. These regulations are seen to have have worked against the goal of providing healthcare at a less expensive rate, making insurance and related costs skyrocket. Whether this is necessarily true is debatable, but I think there maybe some truth to the argument.

How are we to both provide inexpensive healthcare and also ensure the health of the population at large? We cannot sit idly by as millions of us suffer cruel fates because of the free market, just as we cannot let our desire to help collapse our ability to provide these services. We must choose a direction, either one that is less regulated, but may abuse those it provides services to, or one that is given to all of us, and is thus protected from such inequities. Either way, there is no doubt that lawsuits must be limited, and bad providers of services found and kept from hurting people. I don’t think anybody will disagree with that last point.

The best example on the world stage may very well come from a stereotyped people. The French. Sure, the French are the symbol of everything bad to the conservatives, yet there healthcare system may be the very best example of a market driven universal healthcare. A decent jumping off point for future discussions on the ability to help all without hurting everyone in the process.

The Frech system is not perfect, of course, but it does provide a wonderful array of services for almost half of what individual expenditures are here in the United States. The per capita cost in France is about $3500, while in the US it’s closing in on $7000. The french get to see their own doctor, and are reimbursed buy the government for a vast number of services. The individual can chose to get further private insurance for procedures that don’t fall into a basic medical needs category, and thus the extra costs of abuse of the system is avoided.

The system doesn’t have the long waits and poor service that conservatives put forward as arguments against universal coverage, and it’s bureaucracy is limited by the use of electronic filing and streamlined electronic transfers of funds. They limit the costs, and maintain a system that was rated number one in the world by the World Health Association in 2001. Half the cost, and everyone is provided for.

Businesses still provide their employees with extra insurance, as benefits, and a way to attract the best workers. Some self employed even completely forgo the system and provide themsleves with their own full coverage insurances. It’s a flexible system that does a number of exceptional things, while maintaining exceptional savings.

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Crazy McCain, Deregulation, and Universal Healthcare.

September 20, 2008

Opening up the health insurance market to more vigorous nationwide competition, as we have done over the last decade in banking, would provide more choices of innovative products less burdened by the worst excesses of state-based regulation.

John McCain, September/October Issue of ‘Contingencies’

So, let’s make the health care industry just like our ultra safe financial industry! Wow, why didn’t I think of that? Once again, the McCain mantra of less regulation will lead to the free market solving all of our problems. How quaint, you blathering idiot.

This type of wrongheadedness is what has lead us to the financial giants collapsing. Three out of the five major financials have imploded due to this anything goes approach, and the other two are predicted to be going soon (whether by sale or crumbling is yet to be seen).

Deregulating a public need, such as health care, is exactly the wrong thing to do. When industry consolidation occurs in industries that provide vital public services, such as health care or energy, and oligopolies are formed, the public loses. Time and again this has been shown to be true throughout history. They control the profits that they wish to recieve, and the market really becomes pretty much meaningless to them.

Regulation is not the enemy of industry, far from it–it is the vigilent mother who is there to make sure childish industry doesn’t kill itself, and in the process, everyone around them. And, yes, there is just as much imaturity on Wall Street as there is on any playground in America.

“…innovative products less burdened by the worst excesses of state-based regulation.”

Innovative. Sure, it’s damn innovative to create products that collapse giant houses like AIG, Bear Stearns, and Fannie and Freddie. Innovation worthy of Wile E. Coyote. We don’t need ‘innovation’ in our health care system, John McCain, we need to provide health care to everyone.

Health care is a necessity in today’s world. We have the technology and know how to treat, cure, and sooth so many illnesses and diseases, but we only provide these services to those that can pay. I know what you’re thinking- ‘But anybody can use the emergency room!’ – Yeah, and that’s great for a couple pain pills when the cancer is causing a person to writhe in agony. But what of the tumor? What about the (I’ll put this bluntly) less fortunate people who can’t think a worth a damn, and can barely afford to eat and have shelter? What about them? They will never be able to provide for themselves at a level that lets them have the luxury of health insurance.

I don’t think that health care is a luxury, and I damn well don’t think that because of a person’s station in life they should be denied health care. These are people, just like you and me. They need us to help them, but so far we have locked them outside the gates of life, liberty, and the pursuit of happiness. Can we not, as the wealthiest nation on earth, provide for our people on a level with other industrialized nations? Must we shamefully pass off the notion of universal health care as a socialist idea, and avoid it because we don’t want to be like the Soviet Union? We won’t be the fucking Soviet Union, people, we’ll be the United States, the country that welcomed the tired, the poor, and the huddled masses yearning to be free, and we’ll be the United States that made them well again.

As healthcare costs rise in the United States, the healthcare itself is lagging behind the rest of the industrialized world. The US private healthcare system is inefficient, costing the US far more to cover the for-profit administration than other nations. Economically, this is hurting US business through competitive advantages other industrialized nation’s businesses have. Our current system is also immoral, shunning those who can not afford to pay, creating a large population of persons with a low quality of life for no other reason than the inability to pay.

Taking this step is not going to be to the liking of the for-profit health care industry, and John McCain’s lobbyist staff, but it is their very inefficiency and callousness that has brought the universal health care movement into the public debate. The US government already spends more per capita for health care coverage than any other industrialized nation, about $2500. On top of this, private expenditures are about $2000, placing per capita spending above $4000 per person. The fact is that the US already pays more than enough to have universal health care, but instead receives an inefficient private coverage that still places our average lifespan at forty-fifth in the world. Not exactly a good return for a high investment, and the people want change.
The polls tell the story, according to a ABC/Washington Post survey, 62% favor a government run universal healthcare system to the current one, a two to one ratio. The concept of the public rejecting universal healthcare because of the probability of taxes being raised has also been tackled in polling, Pew research found that 67% of people would support universal healthcare even if it meant taxes would be raised, only 29% would not support it. Again, a two to one ratio in favor of universal healthcare, even with a lowest common denominator issue like raising taxes being brought into the question. The public of the United States wants to provide healthcare for all citizens. It’s business that doesn’t want it, even if they should.

Business costs for healthcare have been growing as more and more legislation requires coverage of employees. As a society, we have decided that healthcare is a necessary benefit, and the legislation reflects this. Businesses in the United States are entering a global economy, with competition coming from every port, telephone line, and internet connection. Businesses in most industrialized nations have a major benefit that US companies do not have, healthcare costs provided by the common payment of the citizenry, rather than business and employee. This two to five percent differential in product cost can mean the difference between rapid growth and bankruptcy. It is imperative to give our businesses the necessary tools in order to compete on the global stage.

It has been shown that Americans pay an amount tantamount to providing universal healthcare, without the benefit of the coverage for all. Some estimates put US government funding of healthcare at 64%, with the remaining monies being paid by business and the insured. Conservative estimates place per capita expenditures in the US at $5,700, totaling about 15% of the US Gross National Product (GNP). In contrast, Sweden, Canada, Australia, and the UK spend less than 10% of there GNP on healthcare, yet provide greater levels of service to their entire populations.

The big 3 automakers met with the Bush administration in 2006 pleading for a solution to the burden of healthcare costs. The car makers claim that healthcare costs add between $900 to $1400 per car. That is quite a percentage when the US car makers are in a very competitive market.  By having a universal healthcare system, these large industries would regain a competitive edge they have lost over the years. Lower costs to them means more units sold, and higher profit.

Another interesting economic benefit from implementing such a program is an issue that was debated greatly a few years ago. Bankruptcy in the US has been seen as an overused legal protection from creditors, and laws have gone into place to minimize the bankruptcy rate in the country. A 2001 survey found that the number one reason for bankruptcy in the US was not credit card debt, it was medical bills. About half the people surveyed cited medical bills as the reason for their bankruptcy, and 75 percent of those had had health insurance at the onset of the illness.

Universal healthcare is not just an economic issue, however, morality in public policy needs to exist as well. When, as a nation, we see that over 15 percent of the country has no health insurance, and over 11 percent of children are uninsured, we need to act. These numbers do not reflect a more dire situation, which is that the South’s uninsured rate is over 18 percent, and the West’s is over 17 percent, according to the US Census Bureau. Almost 1 in 5 in these areas—huge swaths of the country—are reliant upon emergency room treatment, or no treatment at all.

It is time to put a universal healthcare system in place. Economically, the US is being punished for embracing a free market concept in healthcare funding, even the auto industry is pleading for reform. Healthcare costs have not gone down because of competition, but rather has increased at a substantial rate, and is the least efficient system in the industrialized world. This inefficiency hurts not just the insured, but the uninsured as well, as they pay substantial portions of their taxes to cover public subsidies for healthcare, but receive none in kind. The issue really isn’t if the US should put a universal healthcare system in place, the issue is how soon can we do it?

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Sources

Angell, Dr. M. (2003). Dr. Maria Angell Introducing the national health insurance bill.

CBS News, (2007, March 1). Poll: The Politics Of Health Care.

Chua, K.P. (2006). Single Payer 101.

Clark, Andrew. “Detroit’s big three seek White House help.” The Gaurdian

Daigneault, L. (2001). Health care systems: an international comparison. Pacific Northwest Regional Economic Conference, 2001

Devereaux, P.J., Choi, P.T.L., Lacchetti, C., Weaver, B., Schunemann, H.J., et al, (2002). A systematic review and metaanalysis of studies comparing mortality rates of private for-profit and private not-for-profit hospitals. 166, 1399-1406.

Good Morning America, (2007, April 26). ABC News.

Himmelstein, D.U., Warren E., Thorne D., and Woolhandler, S. (2005) Illness and Injury as Contributors to Bankruptcy. Health Affairs W5, 63-73.

Himmelstein, D.U., Woolhandler, S., Hellander, I., & Wolfe, S.M. (1999). Quality of care in investor-owned vs not-for-profit HMOs. Journal of the American Medical Association (JAMA), 282, 159-163.

“Income Stable, Poverty Rate Increases, Percentage of Americans Without Health Insurance Unchanged.” Newsroom. 2005. U.S. Census Bureau.

“Rank Order- Life Expectancy at birth.” The World Factbook. 2007. The Central Intellegence Agency.

Woolhandler,Steffie, David U. Himmelstein, “Paying for National Health Insurance–and Not Getting It.” Health Affairs 21, no. 4 (2002): 88-98.