... is it to be???
In looking over some of what I wrote in the past year or so... or should I say in the few
recent posts I made... seems that the health care reform debacle was a topic on my mind. It sure has made it to my Google "Shared Items" list a lot! Since I last wrote, both houses of Congress passed respective, internally conferenced and terribly flawed reform bills. In short, the GOP pretended to be in charge, had the various bills vastly compromised in the pursuit of
"bipartisanship" and, like hookers when the dollars run out, left the johns sitting in the dark without even a kiss (or even the votes)!
Then again, given the
pernicious influences of lobbyists (from the beginning!), big-time corporations and
conflicted spouses, it is really hard to tell exactly
who is the whore and who is the john during the entire health care reform process through the oh-so-dramatic Christmas Eve vote on the Senate floor. At this point, it seems the only people who are going to get screwed is everyone in this country who does not have health insurance now (legal citizens or not), those with modest employer-paid coverage (who are still bankrupted by a medical catastrophe), and, of course, the average taxpayer.
Cui bono? Well, weep no tears for the fantastically wealthy who don't really need insurance anyways ("
cadillac" plans or not) and will find a
scummy ethically-challenged way out of any newly imposed taxes. Nor should one cry for the giant medical-drug-insurance corporations; they are already reaping outrageous fortunes for taking money, and guaranteeing profits by limiting payouts.
Naturally, John Stewart tells the sad saga in a much more compelling way than I could. Including the perfidious role our old friend
Of course, the existing health care "system" in the USA is an immensely complex, interconnected and sadly, profit-driven enterprise. It makes vast fortunes for a small number of Americans while delivering just about every possible health outcome. From stupendous life-saving emergency services, to equally miraculous life-extending surgeries and drugs, to stunning cosmetic makeovers and baby-making, our national health care system does it all. Yet somehow, it also
lets some 4,000 Americans die each month because these people do not have the coverage necessary to partake in this wondrous "system."
Think about that. Four thousand a month! That's like September 11th every third week! And still our Congress serves up a melange of changes that will not fundamentally change the system that exists today (except perhaps to make every Citizen even more resentful of it).
Not so long ago, I discussed this whole health care issue with some friends. As part of that, I extolled the excellence of a couple of shows NPR's
This American Life had done back in the fall. In the first (
More Is Less), looked at why our country spends so much money on health care (because doctors are basically "
pieceworkers"? Or because the patients demand unnecessary tests? Or because the hospital companies extort higher fees from the insurance companies?). It begins to flesh out for you, in a very easy to understand way (despite the David Frum cameo), just how multifaceted the health care "problem" actually is. The second show (
Someone Else's Money) exposed the internal battles between big pharma and insurance companies (guess what, premiums go up to pay off pharma), the insanity of billing administration (and the overhead that must be paid), and the disgraceful dumping of insurance customers to protect the company itself (due to the cost-sharing predicament). Bill Moyers also did an episode called
Money Drive Medicine which is well worth your time.
When you are done listening to these shows, you come away with the realization that complexity and unintended consequences is only part of the bigger problem -- and perhaps the result of what seems to truly be the problem. That is,
the U.S. health care "system" is essentially ruled by three very large, monopolistic trusts (big hospital, big pharmaceutical and big insurance corporations). And, what is missing from any of the reform legislation awaiting conference in the Congress?? You guessed it -- regulation (or even busting) of these trusts.
Once again, everything old is new again. Unfortunately, unlike Teddy Roosevelt, our current President will not be taking up the mantle of trust buster -- he is much more of a McKinley it seems
(does that make Rahm the new Mark Hanna?? he seems to fit the mold...)So, is health care a "right" deserved by everyone?? Or is it a business, deserving its own freedom to generate profit?
This patriot pretty much comes down here:
health care for everyone is a public good that requires public regulation. A utility so to speak. Everyone must have adequate health care to lead the life, liberty and pursuit of happiness bequeathed to us by our Founders. And, like having clean water or electricity, the "delivery system" is so expensive that it naturally tends toward monopolistic behavior which the forces of "free marketism" use to turn their customers into paupers if left unconstrained. Therefore, in the interests of all our good, health care "reform" should seek to push our present "system" towards the public-utility model. I will judge the merits of any final bill passed by Congress (this issue remains in doubt I think) based on the how much (or little) the reform does to move towards this model.
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