Health Care Antidisestablishmentarianism
I read a statement in the press last week - by blue dog democrat that universal coverage was not in his opinion one of the critical goals of health care reform. I combined this various other statements -- including some mixed messaging from the president himself that the "public option" or "single player" plans are not a necessary part of reform either. Even allowing that those last two terms seem to mean different things to different people. I really find myself asking at this juncture (I am prompted towards the past tense): "Then what was it all about?" Is it all just a matter holding down costs? Perfectly valid in and of itself. A key point there, though is the more enrolled in the insurance pools of whatever varieties exist the more risk is apportioned, the more easily costs can be managed. Problems occur when segments such as the wealthy and the healthy calve off the main insurance pools. Also those referred to as the indestructables, 20 year olds believing themselves immune to sickness or harm, who opt out of health care altogether. They inflict costs on the system becoming sick or injured at the same rates as their demographic compatriots. The status quo will only produce accelerating costs. A co-worker pointed to a Krauthammer column
The Great 'Prevention' Myth as a singularity of reason and clarity. I read it and thought Krauthammer was dissembling. The column dealt with a minor and only somewhat useful distinction on merits between preventive care and curative care. Given that a disease or illness will (usually) fall short of afflicting 100% of the population. A health care regime might conclude to place the bulk of resources towards ameliorating the effects of a condition rather than efforts to prevent initial contraction of it, at lesser overall cost. This is a thin contentious argument that not only fails to fall free of the moral trap that affects the mythic though popular death panels, but as well the practical matter that diseases appearing to suggest themselves to this approach do so only because of the enormous preventive efforts already expended on their behalf. This was not Krauthammer's real point. The more emotional weighted language of the first paragraph made it clear his real concern and satisfaction derive from the perception that "In the 48 hours of June 15-16, President Obama lost the health-care debate" and that the Obama's forward momentum had been firmly and permanently halted only a few months into his despised Marxist presidency. Richard Cohen Echoes of McCarthyism From Sarah Palin and Harold Meyerson
Lincoln's Prophecy for the GOP in separate opeds in the Washington Post this week make similar points about this cast of the health care debate. Republican slash and burn demogogory may indeed have limited even ended President Obama's ability to produce health care reform. But it comes at a cost to their own ability to positions themselves as responsible leaders. The ones hurt most are the working middle class. Killing the bogeyman of death panels doesn't keep those loved ones from dying, it just squeezes those discussions into rushed adhoc decisions in a hospital corridor. Meyerson similarly argues the republican party has evaporated more of their own reputation eroding Obama's political capital. A Pyrrhic victory. While they are in little danger of ceasing to be a political party, they are in the process of reshaping themselves as a subculture party.
Tort Reform standing in for health care reform is a misdirection. In a system that chooses to regulate industry as little as possible. The primary tool for citizens is to have ample market choice which the current spider's nest of oligopies simply does not provide, it does nothing to redress injury once it has occurred at any rate. The other possible recourse is to allow the free right to bring suit, and for juries to allow substantive damages that might impel a corporation to change its product or behavior. Tort reform would do little to rein in structural health costs, though it might promote buy-in by health care providers. It would lower medical malpractice insurance costs, but so would removing licenses from the dangerous and incompetent, which is and always has been under the medical communities control.
I am agnostic on the means of health care reform. No fixed interest in any particular approach. Not in making it a federal government project in order to ensure it as a thing of the American people. Nor in handing it over to the insurance companies to appease the sense of entitlement of the private sector. Fearing Government administration seems somewhat nonsensical though. Government programs, are composed of same people, having the same education and experience, as the rest of the nation. They are not intrinsically less capable, or more capable than a private incorporation set to the same task. Any genuine reform must at least attempt to provide elementary coverage plan for those who want one. It should not discriminate -- against the poor, against the the less healthy. It ought not produce coverage holes between jobs or among certain age groups. In care or prescription. Structural cost containment probably can not be handled until the full health care mandate is owned up to and undertaken, and may present a logical second part to reform.
Addendum {Also via Metafilter --
Digital Roam: American health care on (4) napkins! A hand drawn power point gloss to the debate. Best viewed at the slideshow site:
Healthcare Napkins All}. After seeing what else has come by this summer I wasn't surprised by Sen. Joe Lieberman's (D-Conn) recent suggestion that at this point Health Care reform should be left for the next legislative term, or even some other time all together Lieberman says many health care changes can wait - Yahoo! News. A suggestion for Sen. Joe in return. Why doesn't he set aside his health care package and his family's until that day, when he deems it suitable to take up reform again, arrives? The U S health care regime will not collapse catastrophically. It will decay unevenly, become ever more inefficient. Some segments of society will never be troubled directly by the ruin of American Health which will still serve them. In the very long run even they will be affected as the practice of medicine returns to bloodletting, magick, and placation of princes. But portions of this nation will have gotten there already by then.
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