Dr. Quinn, Medicine Woman Part I

I have a knack for being snarkily dispassionate about politics, taking a leaf from George Carlin’s playbook about being a disinterested observer with no investment or stake in political horsetrading. The current debate about healthcare, however, is one time where I have to trip and stumble back into the abyss of giving a shit.

It’s too personal for me not to. My own personal stake in the healthcare crisis as an uninsured woman is irrelevant. It’s the people I know personally who lack insurance despite health problems that are eminently treatable but for want of money that drive my feelings on the matter. I’ve been told that I’m unusually passionate about this issue. Well, so be it. If I’m going to be vitriolic and passionate about anything it might as well be this.

When you know someone who is being slowly murdered to support a wealthy business interest or an ideological point of discussion that tends to get one’s dander up just a wee bit.

So let’s get started. This week Democratic lawmakers have acted as the vanguard in President Obama’s new healthcare reform strategy, selling his proposals in town hall meetings nationwide. I won’t mince words, I detest this reform plan. It’s too much compromise and too little solution. But it’s worlds better than what we currently and laughably call a healthcare system. Anything that can get at least some stopgap relief to the armies of men, women, and children who are uninsured or underinsured is at least something.

The fact that a red squiggly line appears under the word ‘underinsured’ reminds one of how often we don’t hear about this, certainly. While the near 50m people without some form of insurance are bad enough, the millions more whose health insurance will not protect them from catastrophic healthcare problems are just as alarming. If you get a cold you’re covered, if you get cancer you’re SoL. That’s not a healthcare system.

Here’s why:

1) Healthcare for Profit is not Healthcare.

One basic thing you will learn in macroeconomics is that most decent economists agree there are some things a complex society needs that market forces cannot produce or maintain in sufficient quantity or quality. These include lots of taxpayer funded services that we take for granted; everything from the armed forces to the police and fire departments to various municipal EMS services to public parks and green spaces.

America is the only industrialised country where we seem to think healthcare should not be included in that list, despite all the economic alarm bells that should be going off when one turns healthcare into a business.

To put it quickly and dirtily when you move from seeing users of the system as patients to seeing them as dollar signs, you’re going to start rationing care to turn a profit.

Draconian ideas begin to creep into the system. Looking at patients as “risks” instead of, say, “people who need treatment” is what these ideas have engendered.

2) Capitalism Rations Healthcare.

You heard it here first, folks. But really this is easily visible on its face when examined the right way: what else do you call tens of millions of people unwillingly uninsured but ‘rationing’? We’ve heard this term used as a far right scare tactic over and over again in this battle, yet it seems to ignore the fact that the health insurance companies’ lust for profits have rationed millions out of the system.

The reason for this is simple. If your source of income (i.e. profit) is very finite, you will not render goods and services to just anyone. Only those who can pay. When it comes to selling, say, cars or computers or laundry detergent, this suits us all just fine. When it comes to healthcare, it starts killing people.

The reason the concept of “risk” exists in healthcare is because the insurers are for-profit.

3) America has 50 million (and counting) horror stories.

The much vaunted “horror stories” from “socialised” healthcare systems in Canada and the UK are designed to convince Americans that any sort of government-run healthcare plan is going to lead to endless tragedies. This would be all well and good except…

It neglects the countless times insurance-payers have been denied treatment because insurance companies saw them as too big a risk to support. Mind, these were cases where the patients had faithfully paid their insurance premiums. The company found a way to get out of meeting their end of the bargain when the moment of truth came. Only a private corporation could justify this using notions of risk versus reward. Only a private corporation could or would put some 25,000 dollars of its profit margin ahead of someone’s life. Even if we’re supposed to get what we pay for.

This doesn’t even begin to discuss the countless people who have no insurance at all. Where are the dreary television ads warning us using their personal tragedies?

4) Public Healthcare is Preventative (read: Cheaper).

It’s worth keeping in mind the simple psychology behind all of this. If you have coverage of some sort you are more likely to go to the doctor at the first sign of trouble rather than, say, wait five weeks for the symptoms to hopefully go away since you sure as hell can’t afford a useless doctor’s appointment.

If, however, you don’t have to worry about paying for even an intake visit you can catch a serious medical condition early and treat it for far less pain and lucre than you would otherwise be able to. For all those who complain so vociferously about paying for others, the simple reality is that they already are in one way or another. When a person who is hospitalised with a serious illness, insured, underinsured, or not, is checked in and treated they are absorbing resources and quite possibly contributing indirectly to increasing your insurance premiums.

One way or another, you pay. Would you rather pay far less through taxes for preventative treatment or far more through your already onerous premiums for people who’ve been conditioned to wait until it’s almost too late?

5) Public Healthcare is quite American, thank you very much.

In the usual rhetorical shell game oft played by politicians in this country we have been pooh poohed and told that we need to find a “uniquely American” solution to our healthcare woes. This is often in a response to questions about high user satisfaction in other countries that have universal coverage.

It’s, as is often the case with such things, a smokescreen.

Between the highly successful programs of Medicaid, Medicare, and military/VA care, we have proven that public plans are as American as apple pie. This by itself puts lie to those condescending dodges.

But the other reason they exist is in part because of American arrogance. Pride goeth before a fall (yet another Biblical idea that religious conservatives love to ignore). In the mid 1980s Taiwan was emerging from poverty and set about building a national healthcare system. They commissioned a blue ribbon panel to go around the world and study other healthcare networks, including America’s. They rejected ours mostly out of hand and instead put together ideas from a welter of other nations to bring about the highly successful, low-premium, smart-card based system every Taiwanese citizen now enjoys.

Are we too proud to examine what ideas can be borrowed from other countries?

__________

There will, of course, be more to come. This is a broad overview of a rather complex subject. One that unscrupulous power brokers have taken it upon themselves to simplify in a dangerous way.

As I leaf through various media outlets and read political cartoons (rant forthcoming on that medium) I find that the debate on healthcare, particularly from the right, has been reduced to encouraging selfishness and fearmongering. Literally dozens of cartoons show President Obama as a surgeon ‘extracting’ a taxpayer’s wallet. A more interesting sub-genre shows him as a doctor snapping a long rubber glove on and a generic white male representing The Taxpayer bent over before him in a gown.

This continues the long running conservative obsession with anal sex, of course.

But more importantly it shows how right wingers are trying to frame this. Protect your own wealth and screw everyone else. They seem to forget that idea, and how it dominated policymaking over the last two decades, is why taxpayers’ wallets are hurting in the first place.

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