July 30, 2009

stop me if you think you've heard this one before


The debate in the comments section about health care, while lively and interesting, haven't done much to quell suspicion that lessening suffering among sick Americans isn't a priority in this country. Every facet of the health care system is a little fiefdom patrolled by either thugs or busybodies doing their level best to keep things from changing, even if the change would ultimately benefit them.

I just wish conservatives would just start saying what they mean - it'd make things so much easier. They should all sign a petition saying "Life sucks. Tough shit. It's a crazy world, ain't it? Go fuck yourself." I would actually applaud that document, as I agree with most of it, and it has the fresh whiff of pure honesty. Then we could begin the debate in earnest, and actually get somewhere.

Zel. M asked "if you're on a plane and are struck with a life-threatening illness, where do you want the plane to land? If you choose Toronto over New York, you're lying." Well, yes, I'd be lying because I have money and I love New York... but back when I didn't have health care? Roughly 1989-2000? I'd get my ass to Toronto.

You want good health care and a large safety net in case the unspeakable happens? Here's how to do it:
1. make at least five million dollars
2. make sure nobody takes any of it away from you in taxes
3. buy a shitload of health care, and when they deny your claim, spend $750,000 getting yourself fixed up anyway.

God, it's so easy! Why haven't more people thought of this?

Anyway, I don't give a crap. Today was goddamn miserable. Even though I just flew to Colorado for a wedding (for someone I don't know), I suffered through the worst migraine of my everfucking life, complete with auras, dizziness, eye splotches and violent nausea. It was so bad that I left my wallet AND keys somewhere at LAX, or on the plane, or wherever, it's gone. Now I've lost my wedding ring, my wallet and my keys over the course of two months. If I felt better, I'd buy an expensive tennis racquet and smash the FUCK out of it against a telephone pole, I'm so pissed off. Of course, I haven't got a credit card to buy the tennis racquet.

Posted by Ian Williams at July 30, 2009 10:51 PM
Posted by: Megan at July 31, 2009 4:43 AM

Yikes. Sorry for yer troubles.

We found out yesterday that some good friends of ours are being given the "life sucks, tough shit" treatment. His employer, a large mental health care provider, has summarily decided to no longer offer health insurance to any of their employees.

He, his 3 year-old daughter, and his pregnant, cancer-survivor wife have pretty much been told that "it's a crazy world. Go fuck yourselves."

They will squeak by with COBRA until the baby's born, but I'm about ready to march on Washington. Anyone know of any good protests going on?

Posted by: Annie H. at July 31, 2009 5:45 AM

I would march on Washington to get this fuckin bill passed--hell yeah!

Ian, I'm so sorry--hope you feel better and hope Mr. Wallet finds his way back to you intact--with his little runaway sweetheart, Miss Keys.

Posted by: ChrisM at July 31, 2009 6:51 AM

I'm sure we all can agree that this health care policy discussion is far more important than spending days re-hashing President Obama's "stupidly" comment and the White House's short-lived attempt to blame the resulting hullabaloo on the media. I have been sympathetic to whomever is our POTUS ever since SNL taught me that "presidenting is hard."

That said, projecting mean beliefs on others participating in a complex policy discussion is a bit of a cop-out, to whit: "...hasn't done much to quell suspicion that lessening suffering among sick Americans isn't a priority in this country."

Passing laws about health insurance and other aspects of health delivery (which now constitute 17% of GDP) does not remotely equate with "lessening suffering among sick Americans." That is a different discussion. If you had asked commenters to share heart-rendering stories of illness, death, and pleas to end human suffering, I am sure there would have been many.

Moreover, let's not forget that we already have Medicaid, Medicare, and that hospital ERs are not allowed to turn people with no insurance. Those costs get passed on to the rich (i.e., pretty much everyone with a decent full-time job). Since about 85% of people say they like their own health care coverage, it is not suprising that they don't want to risk having it taken away due to govermental actions.

If a single-payer universal heath insurance system became law, there still would be many ill, suffering, and dying people. There still would be poor people given how many new impoverished illegals arrive every day. I am pretty sure that reasonable people would offer various critiques of that system arguing it could be improved, changed, reformed, etc. Others would defend that system and say it should not be changed at all despite its imperfections. I hope no one would demand that those opposed to any change in that system "be honest and sign a petition saying tough shit...go fuck yourself"?

Posted by: Caroline at July 31, 2009 7:11 AM

The whole healthcare debate makes me so anxious. I totally believe in universal healthcare but I'm afraid the Dems wont nut up and just pass what needs to be passed. I don't want them to start stripping good stuff away. I can barely talk about it, it gives me barf-feeling.

More importantly, IAN, your post reminded me that you still owe me a tennis racket. (I'm sorry about your migraine. What do you take for them? Do you have that shot to take around with you? I get them but not bad enough for the shots. And if I lost my wallet I would be beside myself so, I'm sorry. BUT I STILL WANT A NEW TENNIS RACKET.) I'm glad you at least want to buy your own now and not destroy someone else's! Progress is measured in unusual ways. :)

Posted by: kjf at July 31, 2009 8:26 AM

time to go to that meditation class?

Posted by: kazoo at July 31, 2009 8:29 AM

ian, i don't have much of substance to add to the debate today, i've had an atrociously craptastic week (month, whatever, aside from seeing you jokers outside dinner the other night...) and am totally spent just trying to get out of bed and make myself presentable to the office. BUT i wanted to wish you well-er. i'm so sorry you've been hit with migraines AND losing things. disorienting and empty both in their own ways. hang onto lucy and tessa and the shreds of your sanity. much more important those don't go missing, eh? a wallet is just a wallet. big hugs for friday!

Posted by: dean at July 31, 2009 9:03 AM

One of my liberal pals was giving me the usual "the moral thing to do is for employers or the government to supply health insurance."

This friend of mine of well-educated, and a successful businessman. His wife is a stay-at-home mom. I asked the following question and pose it to all you other liberals too:

Assuming it is the moral thing to do, why doesn't my pal purchase health insurance for his nanny? Financially, their incomes are no more disparate than Mr. White Collar and Miss Blue Collar.

It is so much easier to say that you want the taxpayers to pay for everything . . charity begins at home! When the liberals start buying health insurance policies for the landscapers, nannys, cleaning ladies, limo drivers, etc, then I will give them the time of day.

Posted by: Rebecca at July 31, 2009 9:15 AM

Dean: When the conservatives start adopting all the unwanted babies that are born because their mothers don't have access to birth control or safe abortions, then I will give them the time of day.

Posted by: dean at July 31, 2009 9:24 AM

Both sides could use a dose of putting their money where their mouth is.

Conservatives who oppose abortion should never never never allow their kid to get one, I suppose. Kinda like how conservative politicians shouldn't be caught toe-tapping in an airport bathroom.

Liberals who want taxpayers or employers to pay for universal healthcare should provide it to the folks I listed in my original post.

Hypocrisy abounds.

Posted by: Neva at July 31, 2009 9:35 AM

Dean, when I employed a nanny full time we paid her an quarterly amount to use specifically for health insurance. I agree with you on that issue but I feel strongly that everyone else should have coverage and I think getting the government involved is the only way to make that happen.

I happen to agree with Rebecca as well. The number of children I see that are neglected, abused and treated like dirt is just disgusting. I could totally respect the pro life position if it came from someone who is also out there working for better education, health care, and quality of life for all children because he values not just their birth but their whole life.

Posted by: Neva at July 31, 2009 9:41 AM

ChrisM -

Just because people would complain about a universal health care system doesn't mean we shouldn't do it. People complain about Medicare but they sure don't want it to go away.

People complain about public education but do you really want to take that away from our citizens?
I see basic health care as similar to public education.Providing a basic level of health care would ensure a better society for all of us. Would it ever be perfect, probably not, but would it be better for society than the hodge-podge of expensive and highly inaccessible care we have now. I think so.

Posted by: Schultz at July 31, 2009 9:50 AM

I would be 100% in favor of universal health care if the burden of paying for it is fair.

It seems to me that the people who need it most are the same people who pay no taxes.

Jis observin....

"The trouble with socialism is that you eventually run out of other people's money" Margaret Thatcher

Posted by: dob at July 31, 2009 10:45 AM

Dean: Tried to purchase individual health insurance in the private market lately? Nice idea, but unless the nanny is particularly healthy, the insurance companies may not even offer insurance at a price you can't afford.

Schultz: Everyone pays taxes, you numbskull. If not federal or state income taxes, then payroll taxes and sales taxes.

Conservatives: If morality doesn't move you, consider enlightened self-interest. Thing about diseases is that they spread. Same basic reason our local taxes pay for a fire department.

Posted by: Schultz at July 31, 2009 11:18 AM

no shit......but we're talking about a federally driven program not Mayberry RFD Health Plan, Inc.

Posted by: craighill at July 31, 2009 11:29 AM

this was cut and pasted from a column andrew adams wrote but he makes some good points that may not have made the board here....

We should cover the background of the current state of health care first. In 2004 health care was a 1.79 trillion dollar industry which is about 15.5 percent of the national GDP and also roughly 1/6 of our nation debt. There was average spending of $6,167 per person on health care related costs in 2004. I wouldn’t be surprised if that has gone up in recent years.
The Census Bureau states that there are 46.577 million people in the United States without health care. That seems like a lot. But who makes up that astoundingly large number? The first 9.487 million are what liberals like to call undocumented workers, and what the law likes to call illegal aliens.
What we’re left with is about 37 million American citizens that are uninsured. That still seems like a lot, especially in the richest country on Earth. However, not all Americans are uninsured because of poverty. There are 8.3 million Americans that are uninsured that make between 50 and 75 thousand dollars. At even the low end of $50,000 an individual could certainly afford health insurance if they so chose. But they’d rather spend it on better vacations, a bigger TV, maybe even a better house and that is their decision. But someone who earns above $75,000 would certainly buy health insurance, right? That’s not what the facts say. There are 8.74 million Americans that earn above $75,000 per year and still decide not to buy health insurance. And in America they should have that freedom even if we consider it irresponsible.
Out of 37 million uninsured Americans, 17 million are easily wealthy enough to afford it. That leaves us with roughly 20 million uninsured Americans that make below $50,000. Many of these uninsured Americans actually qualify for programs like Medicare or Medicaid but never take the time to sign up, or don’t realize they are eligible to sign up. Taking this into account, the liberal non-profit group, Kaiser Family Foundation, finds that only about 8.2 million uninsured Americans earn below $50,000 and don’t qualify for government programs. That means throughout America less than 3 percent of Americans can’t afford medical insurance and don’t qualify for any current government programs. And it’s not even that bad. The Congressional Budget Office reports that 45 percent of the 8.2 million that fall through the cracks will be uninsured for four months or less. In reality, less than 1.5 percent of all American citizens will go without insurance for longer than 4 months. This goes to show that the free market will correct itself, even without government intervention.

Posted by: dob at July 31, 2009 1:25 PM

Craighill, if you think the free market will correct itself such that everyone gets health care, you've got another thing coming. The free market could give a shit if everyone gets health care. If someone is too poor to afford health care, or any other basic necessity of life, the free market will simply watch them die. That's just the way it is.

If you're happy with that state of affairs, man up and admit it, that's all Ian is asking. Me, I'm not. My dad is self-employed, in his early 60's, and has had Type-1 diabetes since he was 19. No one will sell him health insurance at any price. I don't think that's fair, I think our society should guarantee him access to health care (that comes without the risk of bankrupting him and our entire family).

(The fact that the market for health care is not free for any number of reasons is almost beside the point for the purpose of this particular discussion.)

Posted by: dob at July 31, 2009 1:30 PM

Look at that free market correcting itself.

Posted by: Schultz at July 31, 2009 1:52 PM

so how do you explain the current bill's Quality of Life Adjustment? this proposed legislation essentially is an actuarial exercise to deal with older, sick patients. it seems scary to me.

Posted by: dob at July 31, 2009 1:58 PM

Medicare already covers older, sick patients. They get a good quality of care for the most part. It's unclear to what you're referring by Quality of Life Adjustment, but if it's the bits that add palliative, hospice care to Medicare, I call that a blessing.

Posted by: Schultz at July 31, 2009 2:41 PM

you are right...medicare does cover that. I believe this clause is for those that don't qualify.

I agree with you 100 percent about palliative care and personally have a lot of experience dealing with the 'life at any cost' position.

unfortunately, I think the majority of others will not like the government denying care and telling them 'good luck, here's a consolation check'.

I wonder how many of our senators and representatives will trade in their private plans for the new government alternative?

Interesting times indeed....

Posted by: ChrisM at July 31, 2009 3:12 PM

Hi Neva,
I think you misunderstood the point I was trying to make. It was really about the level of discourse about these very important and complex issues.

I was trying to demonstrate my point by posing a hypothetical "what if the shoe was on the other foot" scenario to show the pro-universal-single-payer folks one aspect of a future where universal single-payer health care is the law of the land in the U.S.

Before long, these good folks may be placed a position of having to choose to fight to defend the new stautus quo even though the system cannot be absolutely pefrect. Nobody's pefect, right? Or, on the other hand, they could push for certain improvements, reforms, or other changes in the system. Well, I wonder how the generous, humane people who want zero change will like it if the people who want some changes start calling them nasty names and imputing selfish motives proving they don't really give a shit about sick, diseased, and fragile, suffering beings.

I believe these generous and caring humanists defending the status quo would be deeply hurt by such awful criticism. Right now, however, these same humanistic progressive are angry and directing nasty ad hominem attacks at mainstream people (like me) who would realy love for people to have decent health care and reasonable prices (and subsidies for the truly poor), but strongly disagree about how to achieve these lofty goals.

Neva, I hope that clarifies things.

My interpretation of the evidence tells me that a national free-market insurance system (where people living in one state can buy health insurance sold by a company based in any other state) will bring insurance costs down for most people. States goverments need to stop forcing all insurance companies in a state to provide specific coverage to all, whether they need it or not. For the poor, "health care" stamps that accepted at doctors and clinics (not ERs) and subsidized catastrophic insurance could make a huge dent. Finally, it is time to disentagle health insurance from employment. It is outmoded for today's more mobile society and workplace.

Bell well all and enjoy the weekend!

Posted by: dob at July 31, 2009 7:21 PM

My interpretation of the evidence tells me that a national free-market insurance system (where people living in one state can buy health insurance sold by a company based in any other state) will bring insurance costs down for most people.

Your suggestion says nothing about mandating that insurance companies offer a single-price basic policy to all consumers. Absent that provision, no insurance company in their right mind is going to sell insurance to high-risk consumers like my father at any price he could afford, competition across state lines or no. If you allow insurance companies to segment the risk pool and price accordingly, as would be the most rational business decision, high-risk people will get priced out of the market, that's the way insurance works.

Why not look at the successful examples from the rest of the industrialized world, where health care costs are less than half of what they are here, per capita, and the citizenry enjoy better health care outcomes? Not to mention, where 700 thousand people don't have to declare bankruptcy every year due to medical bills. That's not just a moral failing, that's dare I say it, a market failure.

Posted by: T.J. at July 31, 2009 8:58 PM

"Finally, it is time to disentagle health insurance from employment. It is outmoded for today's more mobile society and workplace."

This is a huge one. Untie it from employment, make it 100% deductible (or even a 100% tax credit), and allow a lot more flexibility and choice in amounts, extent, and price of coverage. Then you can choose catastrophic coverage if that's all you can afford. And it's possible (I know no one from the left would be believe this could happen) that some companies might offer different coverage, such as covering a treatment, then debating whether they should have covered it later (rather than denying coverage at the outset).

Posted by: emma at August 1, 2009 3:13 AM

Neva - do you know if your nanny used the money allotted towards health care to purchase health insurance?

Posted by: Neva at August 1, 2009 4:06 AM

Yep, she did. Her husband thanked us specifically for it. I know she was getting health insurance b/c I knew her doctor. I guess if you are worried about that you could always write the check directly to the insurer.

Posted by: dob at August 1, 2009 7:51 AM

For the record, I myself was a nanny, and was compensated for and purchased health insurance, thanks to my liberal employer.

Posted by: Rebecca at August 1, 2009 10:33 AM

My housekeeper and her daughter are covered by state run health insurance. At least they were, but now that CA has cut many of those programs, they may be out of luck. They qualify because she gets paid cash by everyone she works for. She won't even take a check.

Most of the landscapers, nannies and housekeepers seem to do it that way. (Although most will take checks.) Have you ever tried to hire someone legally? When my last baby was born, I went through an agency and wanted to legally hire someone - yes, I was willing to pay for the taxes, file the paperwork, etc. 4 of the 6 I interviewed were willing, but EVERY ONE wanted me to gross up their pay so that they took home $18 per hour after taxes. Ummmmm... no.

Posted by: Zel M. at August 1, 2009 4:37 PM

I say again, for those of you who want to play the hypocrisy card:

When Congress says this health care plan on the table is good enough for them - that is, when they do not exempt themselves and the executive branch (i.e. the president himself) from the plan - then I will give this plan more serious consideration.

Posted by: Randy at August 1, 2009 7:16 PM

Zel M. hit the nail on the head. They win the Kewpie prize. Has anyone taken a look at the kind of benefits a Senator or Congressman gets. It's a pretty sweet deal being a "public servant".

Posted by: Claudia at August 3, 2009 5:42 AM

Rebecca, with all due respect, your last comment boils down to the fact that hiring someone on the books simply costs too much money. I make no inquiry whether your refusal to do so stems from inability or unwillingness. Um, this is the issue a lot of people have with universal health care.

Incidentally, those that pay cash so domestics can get benefits that the state only offers to those who make below what these domestics really make shift the burden to pay for these same benefits to those that...actually pay the taxes on their domestic employees (not to mention the time spent with all the paperwork headaches and hassles). So we wind up paying double.

Posted by: Bud at August 3, 2009 9:52 PM

"The debate in the comments section about health care, while lively and interesting, haven't done much to quell suspicion that lessening suffering among sick Americans isn't a priority in this country. Every facet of the health care system is a little fiefdom patrolled by either thugs or busybodies doing their level best to keep things from changing, even if the change would ultimately benefit them."

Yep. And the anti-reform comments on this and yesterday's post reinforce that notion further. The number of straw men and red herrings -- and of course, the disingenuousness (or is it genuine ignorance?) -- are simply breathtaking.

That the greatest country on earth is also among the stingiest is a disgrace. Putting profits ahead of people is nothing to be proud of. It's time to fix a system that doesn't work. Lead, follow or get out of the way.

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