01 September 2009

Health Care Wank…Continued

My irritation with this debacle (no longer a debate folks, it is a debacle) knows no end. While I am willing to concede that this will not be perfect solution to our nation’s health care crisis, I am not willing to let is be taken down by ignorance. I have so many points that we will just skip to a list…otherwise this will quickly become my policy dissertation to finish up that elusive M.S. in Epidemiology.

* Not all who lack insurance are undeserving of it. The uninsured are not, by definition, lazy, stupid and greedy. The inability to pay the ever increasing premiums (or the perceived inability to do so, for most American’s these are synonymous) does not make a person a system milking dead beat.

* You can not separate the concepts of health insurance from health care. For most of our country being able to afford the monthly premiums that mitigate the rising cost of health care is the exact same thing as being able to afford to see a health care provider. While there are some populations for whom paying cash for rarely used care is a better option, these groups are the exception, not the rule.

* Health insurance is not the same thing as car insurance or renter’s/homeowner’s insurance. For some reason we, as a society, place a premium on the value of human life. It’s nutty, I know. The only true parallel is that the bills generated by uninsured drivers and sick people get paid via “charity” monies generated by the taxes and insurance premiums of everyone else. It may not be “fair” but hey, we are paying for this cost anyway, why not standardize the whole system. Additionally, in a topic that clearly will need an entire essay of its own, I wonder how many people are pro-life and anti-public option insurance. Interesting conundrum no?

* To say “it is not my responsibility to pay for others” just makes you a hypocritical asshole. You can only say this if, and ONLY IF, you never went to public school, went to a private college utilizing no government subsidized loans, passed on cash for clunkers, never used a public park and never, ever, utilized any tax credits to which you were entitled due to say, having kids, buying a house or upgrading to Energy Star appliances. The list of what we all do day to day that would not be possible if it weren’t for the concept of “the common good” (insert Hot Fuzz joke here) is endless. Basically by that logic you must reject the offer of a Pell Grant because it is not my problem that you didn’t get a paper route at age six to start your 529. Better luck next time. Most people would be surprised to learn their houses are 95% glass. Well, at least until the stones start flying.

* The abortion drama-llama. I am not sure why this HAS to be a sticking point. Regardless of where you fall on the pro-life/ pro-choice/ pro-death spectrum, pregnancy terminations are a valid medical procedure. Whether “elective” or medically required, to leave a woman/family who had to make that choice high and dry for coverage would border on inhumane. The perceived ethical and moral issues that surround abortion don’t make it less of a medical concern in the eyes of health care management. Sorry folks. You cannot hold up public policy progress based one's personal belief systems.

* People don’t like “health care rationing.” Well, bad news kids, your current insurer does it all the time. While I am not implying that all insurance companies are the devil-incarnate, they are for profit businesses. Everything your health care provider does has to be justified to the insurance companies. If Blue Cross Blue Shield thinks support hose are “good enough” for your varicose veins the size of garden hoses, then no chance on getting the corrective surgery covered. (True example, with some hyperbole for effect, from a family member of mine.) That is real rationing. Government health care will not stop the necessity of such rationing (not everyone needs a full body MRI to deal with nosebleeds, fair enough), but it may empower providers to make better diagnostic and treatment decisions that may even be based on, hold on my friends, evidence based research. Say what now?

* Illegal aliens? Mind you I hate that term, but for the sake of clarity, lets just run with it. This is a real sticky spot. While I would argue that anyone who chooses to live in our fine country, work within its borders and therefore contribute to society deserves to utilize the offered public services, I get why this may rub many the wrong way. From a purely economical point of view, I see how offering government run benefits to a population that does not pay into the tax base is problematic. I am not sure what the answer is here. Granted, we pay for their care now, and maybe the requirement of all citizens to have insurance will help locate those who are not citizens and thusly get them on the track to becoming so (or lead to massive human rights violations via mass deportations, so yeah, this is worth investigating…). This is a murky issue, but not one that should put the kibosh on the whole public option plan. Also, we do have to consider international health care amnesty. If you get sick in countries with “socialized medicine” you are not denied urgent care because you have private party insurance, so clearly other countries manage just fine. I bet we could too.

Maybe I am just a bleeding heart (well, yeah I am, lets just put it there), but having such health care reform is more than just economics and social theory. It is a moral imperative. I think it is time we became the sort of country that takes care of its people, and their health. This article really sums it up so well: I'm safe on board. Pull up the life rope By Roger Ebert. It says a lot of what I said here, though I swear I had started this draft prior to reading it, great minds I guess, but really explains quite well why we have to do this.


Kerry said...

You're absolutely right.

But unfortunately, people get the government they deserve...and apparently the healthcare reform they deserve too. Since we're surrounded by idiots, I fear we might be screwed.

I hope I'm wrong, but I'm not optimistic at this point.

Alexis said...

Good point, the good and bad news about democracy is that majority tends to rule. Unfortunately, people, as a group, not individuals, tend to be a stupid and panicky entity.

Let's keep our fingers crossed!