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It's a Public Service, so Health Care Should Be Publicly Funded
Is health any less central to our lives than defense, firefighting, or the interstate highways?
When I last wrote in this space about a health insurance public option, it was 2004.
I lamented the fact that more than 40 million Americans lacked health coverage and suggested that the private corporate model seemed incapable of righting this wrong. (My opinions on this topic remain my own, and do not reflect my employer's views.)
Since then we have endured five more years of fiddling with free market solutions -- while Rome is burning.
We are now told of some 46 million uninsured (National Coalition on Health Care), of 86.7 million who were uninsured at some time during 2007-2008 (Families USA). It is chilling that these numbers pre-date the current recession and thus represent a rather pathetic best case. And we are now witnessing the demise of venerable corporations like General Motors, a demise attributable in no small part to the crushing burden of purchasing health insurance for workers and retirees.
Our nation's manufacturing base operates at a profound disadvantage to those in countries with more extensive public funding of health care.
We are also told that a clear majority of Americans (65 percent) want systemic change in the funding of health care, including an expansion of the public option now represented by Medicare and Medicaid (Kaiser Family Foundation, June 2009). And yet, despite the mandate for change that seemed clear in the November elections, our political leaders continue to dither.
Sen. Olympia Snowe is praised for dipping a toe in the water with her standby option, a publicly funded plan to be implemented only if the private sector "fails to deliver."
How many more chances are these guys going to get?
Never far from the political debate is the drumbeat of fear and cries of "socialism."
The emotional impact of this has escaped the bounds of the debate and taken on a frightening flavor of paranoid backlash to the Obama administration's reformist initiatives.
While socialism in the Soviet idiom would be a terrible prospect, we would do well to recognize that in attenuated form it has been in our midst for ages.
Public services such as police and firefighting simply do not lend themselves at all well to a private subscription model. Similarly, defense is best delivered by the federal government, as recent experience with Blackwater Corp. would remind us.
Our transportation infrastructure, for better or worse, is largely a product of public planning and funding.
Why not medicine? Is health any less central to our lives than the interstate highway system? Can we not agree that the denial of health care is simply not acceptable in the world's greatest democracy?
Critics of a public option are legion, and they point with justification to the inevitability of waste and inefficiency in government programs.
Yet, despite its imperfections, Medicare, the closest we have come to the socialist model, delivers about 95 cents on the premium dollar to actual health care, while private health insurance, after paying executives, shareholders and other administrative overhead, delivers about 84 cents (Council for Affordable Health Insurance, 2006).
Add to this the monumental cost incurred by hospitals and doctors' offices that have no choice but to hire armies of administrators (each delivering no health care) to manage the morass of conflicting insurance plans. The free market has given us a system of care that is nothing short of a Tower of Babel.
A March 2002 report from the U.S. General Accounting Office cited a statewide median of 28 licensed small group insurers, ranging from four in Hawaii to 77 in Indiana. To be sure, this has created a veritable jobs program for managers and bureaucrats, and this growth sector would be adversely affected if our health care dollars were reallocated to actual patient care.
This cadre of MBAs and others, relative newcomers to American health care, have become parasites at the feast.
They have the most to lose in reforming our dysfunctional system and have helped to orchestrate the chorus of fear about a public option.
It is my hope that we can marginalize the fear-mongers and accept the reality that the corporate model, while leading to fabulous riches for the few, has failed Americans.
Private choice deserves to survive (we are not, after all, the Soviet Union), but it is time to give up our broken system and to place public funding at the center of reform.
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45 Comments so far
Show AllWell done! I'll email a copy to a local news show that just talked about "gummit-run healthcare" as if the journalist had no knowledge of the truth or interest in reporting it. It's pretty sad how misinformed the pubic is on this.
The Right wants us to take pride in being ripped off by insurance companies as if it was a privilege soldiers had fought and died for in WWII, or that being scammed by those buying off your representatives in Washington was patriotic. Freedom? Peasants are free. Free to be ignored by government and starve quietly while the rich step over them.
"Private choice deserves to survive (we are not, after all, the Soviet Union) ..."
That pronouncement, based on the false premise of mutual exclusivity between public funding and a patient's own care choices, has to be nearly as stupid as calling the U.S. system of corporate-owned governance "freedom and democracy", but sadly typical of how such issues are debated by USA Incorporated. They choose the terminology and its definitions, along with a few "patriotic" emotional red herrings, and the "sheeple" follow right along.
The code words that we use and the way we've been conditioned to think when we hear certain words does get in the way.
But a two tier health insurance system would be an improvement, a private and a public plan. Some European countries use basic (public) and extended coverage (private), Canada has one tier for health care.
With single payer I DO get a choice.......of doctors and isn't that what most of us want?
The only choice I would miss is which "insurance?" company standing between me and my doctor will be a leech on me and my family's economic well being.
Exactly. Why would anyone want "free choice" of insurance plans, when the very need to choose them could be done away with altogether?
Say someone came up with cheap tooth treatment that could be publicly administered and do away with ever having to see a dentist. Would the dentists oppose it by saying it is removing poeples freedom to choose a dentist?
There are many such instances of phoney, manufactured "choice" - which invariably replace other choices people once had - in capitalist economies.
The case against single payer health care insanity isn't just limited to Washington alone. A while back, I talked to one of my friends from work about single payer health care and she rambled "Oh big government care?". Everyone laughed like mad when they heard it. I tried to explain to her about it and yet she kept saying "Oh, it's nothing but commie care. Your ailing wife is recovering because you helped her, not big government." I explained to her that the burden of expense on one helping his/her ailing spouse is often high as it was in my case. Then she goes spouting some more nonsense about government "Government is not there to give you free health care. Government is supposed to defend this country and give us cheap oil. I want my oil cheap and I want it NOW !" As usual, the rest of the crowd acted so idiotic in their laughing and one old man even said "Stop being a f***ing commie sonny boy or take your sorry a** to another country ! We don't want no damn socialists here !" Laughter as always. I should have been trying to bail her out of trouble at work but the more mean and immature she sounded, the less I felt like helping her out. I finally told her that she can help herself and then she ranted "Well, even if I get fired thanks to you, well I can find another job because I don't need no silly big government care. Nananabooboo !". I tried again to explain to her but then she acted so childish and even covered up her ears and sang "a-la-la-la". One of the folks in the crowd even threw a pie in my face and then I left in disgust left her to eat and pay up. Well, she got fired later that week and it has been 3 months since she has been unemployed from what one of my coworkers told me. Maybe she'll understand single payer especially when unemployed ? I doubt it. Sorry to blabber here but I just thought I'd share what I had to put up with out here in LA and there's plenty of hick mentality that never ends ! They love wars and wasting more money on that pile of BS but healthcare? Nope, somehow to them, funding healthcare publicly is a waste of taxpayer money ! And my state is still reeling with exorbitant health care costs thanks to all that oil drilling over the decades and the chemicals released into the air from it !!
Bennett Miller
Shreveport, LA
Thanks for the story. Emmigrating to another country is certainly an option. A brother of mine moved to Canada. For the first time, he can see a doctor without facing debt and a collection agency.
I wouldn't mind emigrating but in addition to my wife missing the US, I still don't think that running to Canada will help. I hear that even there, the same hooligans who sabotaged any chances of single payer here in the US are working on sabotaging the health care system in Canada. I'm not about to give up standing up to the hick mentality crowd even if this state stays stark red and drowns as a result.
Bennett Miller
Shreveport, LA
You're pulling my leg, right? They didn't actually speak that way?
Why do they speak in political slogans..."no big government"..."stop being a commie"..."no damn socialists"
Would it be worth your while to explain the notion of insurance or the science of insurance (actuarial science) and how using a larger risk pool minimizes the cost of benefits and therefore that single payer is the most cost efficient insurance system for health care?
Phasor, you can't reason with such people. I encounter them, too, including members of my own family- who watch Fox and listen to Rush. My mom is convinced that, if she's still around when it's time for another bypass surgery she won't have to worry because- with "socialized medicine" that the Democrats pass- the government will keep her from having access to such care. These types are so brainwashed by the opposition's propoganda that they won't even consider any fact-based, logical arguments. America has the "best health care system in the world"; if we did not, why would people come here from these countries with "socialized medicine" to get their care?
Such lessons learned the hard way. I couldn't even get her to sit still when I tried to discuss the fallacy of these health insurance companies. The dumbest thing she would say is "My insurance company is so close to where I live but government is too far away !" I asked her to give the address of her insurance company and she went blank and then shouted more anti-single payer bs and even banged the table like a kid throwing tantrums ! As to the guy who threw a pie on my face, he said "Let's see government pay for your face damage !" and laughed as did the rest of the immature crowd. I've known half of them before. They sound nice and all when you meet them individually but they typically watch NRA TV, O'Reilly, Hannity, and similar. I did stumble across one of them who complained about his insurance company but then told me "Well, it's better than what big government would do ! I'd rather get shot by the insurance companies than by big government !" Yet this same man doesn't realize that both are collaborating to rip him apart. I feel sorry that your own family is treating you badly like you described.
Bennett Miller
Shreveport, LA
I was the only one in that crowd who actually knew better on single payer so I was in the minority. I was upset and angry but since I'm not a blue-collared worker but an educated worker, hitting him back was not my style. I have had to put up with the hick mentality in this otherwise great state of Louisiana. I really feel sad and sorry for these poor fools. They really are in serious denial mode. I can only hope that someday either I'll be successful at convincing them or they'll see for themselves. I'd hate for them to see it the hard way but Lord knows what's in store for them.
Bennett Miller
Shreveport, LA
Benn, My husband and myself know EXACTLY what you are dealing with and empathize. I used to be very frustrated about the whole thing, but as life flows, one by one the co-workers see why you've tied logs together to make a raft. The one gal that walk-a-thons to get pledges to help her sister with breast cancer. The next family that holds car washes and bake sales to get enough gas money to go to the specialty hospital 300 miles away to visit the child being denied the liver transplant she needs.... We all have these stories of people going through this, still coming up with Rush Limpdicks talking points about health care.
I try to look at it like this (self-talk) "I would love to write off these ignoramuses, they just refuse to be educated." " I know but they are the salt of the earth, they did help you push your car to work, so it wouldn't get towed." " Yeah, that's true their heart seems to be in the right place. Maybe I just have to look at them like Jesus probably looks at me. HE probably just shakes his head and says" she's doing the best she can, with what she's got and if I just wait, she'll wake up with that experience that's coming..." It really does help. Also, keep the lecture short. 3 sentences or less. It gives them time to process. I also share, "I don't say this, or think this or know this because I'm smarter than you, because I'm not. It's just I've had more experience in this nightmare we call US health care because of my husband's 25+ years chronic illness. That's all."
I think a lot of the denial mode comes from feelings of learned helplessness. "If I believe what Benn and Minnow are telling me, I'd have to do something about it and I don't know what to do. And what they're doing doesn't seem to be working or this problem would be gone." Cognitive dissonance makes some people shut down and it makes other people fired up. Keep it up, Benn.
Benn_Miller, I hear ya. We get this same kind of foolish madness out here in Mississippi. Some conservatives support single payer health care but often it's only when they learned their lessons the hard way such as getting ripped off by the insurance industries, the drug companies, corporate trial lawyers, or a combination thereof. As to your friend who laughed at the idea of single payer, you might want to try convincing her again. If she has suffered enough from unemployment for 3 months, she might be a little more mature and receptive. Don't give up.
Pennsylvania has its share of crackers too. I think we should let them opt out of a mandate or if they can, choose a high deductible private plan. But if they get sick, have no money to pay--we should say--that's free enterprise--and encourage them to do the economically prudent and moral thing--end their lives rather than be a "burden" on others. "Why should I pay for someone else's health care"- they whine. "I've always been able to take care of myself"--they brag, Fine, I say, go you own way but don't expect me to do anything for you when you need help.
No worries to those clinging to the status quo: No form of single-payer is "on the table".
If you want health care, public services and human rights a bit better than can be had here, move to France, Netherlands, UK, Denmark, Norway, Italy, Sweden, Finland, Germany, Spain, Czech. Rep., Belgium, New Zealand, Canada, or Costa Rica.
Yeah, single-payer healtcare will come in your delusional dreams of fantasy. You expect those disgusting Conservative Democrats who may as well be Republicans to change? The Democratic Party is run out of the Democratic Leadership Council's office which supports the military-corporate state as much as the Republicans do. You all can give a big Thanks to Obama's Chief of Staff Rahm Emanuel that those DINOs exist in the Democratic Party as well! The Democratic Party is useless and so too is President Obama, Vice-President Joe Biden and Secretary of State Hillary Clinton. The Obama administration and the criminals in the Democratic Party-led U.S. Congress show that they are warlike, warmongers and promotors and defenders of the military-corporatist state by continuing to suppport the bloated military budget and wasted military adventures in Iraq, Afghanistan, Pakistan and paying for all of America's military bases worldwide. Obama's military budget is higher than Bush's at this time as well. Obama, Biden, Clinton, Emanuel, Panetta, Pelosi, Reid, Durbin are all war criminals along with so many more Democrats, and Republicans, of course.
Obama is a Big FAILURE!
Obama's healthcare plan can be equated with a euthansia plan and the sooner you knuckleheads face this harsh reality the better off you will be. Get your heads out of your butts! Face facts folks--Obama and Biden are war mongers who back the military-corporatist state and most Democrats in the U.S. House and Senate are conservatives, and not liberals or progressives. Until the next time, I am sure all of you will keep busy in those Democratic Party delusions and yes the illusion that Obama is such a "great leader."
Obama supports the Banksters not the workers in America. Have fun when your money means nothing and very soon too. Obama will keep lying to with you with a smiling face. The laugh is at your stupidity though. Wake Up Already! The old days are long gone folks. Stop looking at the USA as you did twenty or even ten years ago. Those times are gone forever. Things will keep getting worse and you will have no place to turn as state's become bankrupt and jobs are less than even now. The Stimulus even at this point is nothing but a band-aid without real structural change which the political and economic elites are against. Welcome to your new Serfdom status. Get ready to work as neo-slaves. Wake up out of your stupors folks!
Don't you people realize that the America is a FAILED STATE NOW? That any other country would be under the control of the IMF and World Bank right now? Wake Up because America has Failed and you still want those who allowed it to fail to Fix It for Ya! Man, you people are DUMB!
Liberals and Progressives are very impotent.
Stop BITCHING IF YOU REMAIN IN THE DEMOCRATIC PARTY. ANYONE BITCHING HERE TODAY WHO DOES NOT JOIN THE GREEN PARTY IS JUST YELLING AND COMPLAINING IN VAIN WITH YOUR USUAL FAKE Liberal/Progressive WHINE(ING). STOP IT BECAUSE IT HAS BECOME TIRING LISTENING TO YOU FAKE Liberal/Progressives who actually thought Obama or that the Demnocratic Party---also a party of the military-corporate state was gonna bring any real "change." You so-called Liberals/Progressives have become very pathetic! The Democratic Party is not an ally of Liberals and Progressives so get into some reality.
Obama is not a Liberal/Progressive but the newest face on the fading of the American Empire. Obama being an "environmentalist" is like saying the Mafia never killed anyone. Obama is not trustworthy and you dolts keep thinking he will achieve substantial changes in the failed political system.
Hey man, I am angry too and I agree with your points, but please stop with the "you people are dumb" sort of thing, it won't help your arguments.
Wake UP!
Okay--if not "dumb" than very naive and gullible!
I guess the harsh truth never works on this dumb American public...sorry but people are dumb and I must use the word!
This is no longer about "argument" but survival!
Then someone call a general strike or some massive civil disobedience. That is the only "way forward", given our corrupt political process and institutions. I sent Michael Moore an email to do this, but he is too busy supporting Obama, smearing Nader, making documentaries and making big money.
Someone from the Left that has some unifying and mobilizing powers needs to step up.
Screw Michael Moore and the rest of the limousine liberal crowd. Waiting for them is a fool's errand!
Wake Up!
Re-read my post! What do you recommend then smart guy?!
Get your head out of the sand! If you advocate Action, what do you recommend?, screaming and yelling at the choir aint gonna get it done.
Back at you too!!!! Get off your duff!
You have no idea what I do for action!
Are you really or actually aware of how the political and economic system has failed in America? Are you?
Don't you realize that any other country would have beem taken over by the IMF and the World Bank at this time?
Are you aware that state's have no money? I mean none and many cannot meet their budgets at the time they are due? That Governors around the country are more busy vetoing budgets than signing them? That all kinds of cuts are being made from social services to Medicaid to Education? And you want me to say, for instance, that Americans who vote in referendums over the years against their own best interests are not "dumb"? Please already!
Americans are dumb! I am sorry, but, Americans have themselves to blame for all the present mess this country is in by going along with whatever the elites in the media, entertainment, politics and economics have fed them over the last twenty-thirty years.
I saw this America as a Failed State coming when Reagan was president. I choose my words wisely and in my opinion, the word dumb is very appropriate, no matter how harsh it may seem. Sorry, but, the truth hurts. Americans care more about spectacles than they do about truth and real knowledge.
So you don't advocate a general strike or massive civil disobedience? How disappointing
I supported this back in the 1970s......it never happened then....when the workers still had great leverage in the system....
I would support an idea as long as it had distinct purposes with achievable goals....
Generally, I do support it though....I am not your enemy either....
You can choose to distort my posts as well....I am sorry but exaggeration is part of writing and making one's point whether others like that form or not....But, unfortunately, there is great truth in many exaggerations of society....Artists and filmmakers do it all the time and people go to those spectacles.....
The exaggerations I make are not spectacles either....I find many so-called "liberals and progressives" to be quite phony and fraudulent in their beliefs and actions when the rubber meets the road.
I am a Radical....not a liberal or progressive....
Are you really or actually aware of how the political and economic system has failed in America?
Are you?
We all know this, you aint tellin the choir anything new! What do you propose to DO about Mr. ACTION??? Claiming to be "holier than thou" aint helpin either
Sure that you are not acting "holier than thou" yourself?
Seems like you are projecting your issues here since you brought it up, but I cannot say so for sure.
I have seen your posts here before and I can say the same thing about you, but I will not. I am sure you are a very smart, intelligent, wise, and active individual with no delusions or illusions.
I am not here to please you either by the way.
Your reactions to my posts are interesting though.
There Is No Alternative
"To what?"
"Our rising up en masse."
"Otherwise?"
"Doomsday."
"Based on?"
"Perpetual war + global warming + economic collapse."
Why cant everyone have insurance? The lazy people in this Country that has never paid in any taxes can go out and get two or three babies and live with the baby maker and get anything they want. Free rent, housing, food and insurance. The tax payer cant get a damn thing unless they pay for it.
Single Payer Coverage
or
Death with Dignity
A chronic disease without Medication or Medical Treatment truly is "Torture."
...and education, and food, and shelter, and clothing.
"They would be totally dependent on the government and the government will have total control over its citizens."
Not if the people, not bought politicians, are the government.
Privatized public service is an oxymoron.
And what other "public services" can we place under the funding and control of a "benevolent federal government"? Food of course is more basic than even health. Housing? Our public schools work so well that many progessives and liberals seek out private schools. What about transportation? Surely travel to work, shopping, and school should be provided. Where do we stop?
The question of course for health care reform, is who benefits? Doctors benefit from single-payer systems. Fees become fixed and non-competitive, office staff is laid off, and government guidelines provide significant protection against malpractice actions against them. We certainly want to keep all of our doctors (including George M. McNeil, M.D.) from living in poverty.
Who else? Politicians get to pontificate for decades on "keeping the health system solvent" and consolidate power by scaring anyone who might run against them with fear of "cuts" in program funding.
Instead of loading incompetent government drones with running a complex and highly technical business like medicine, why don't we get rid of the barriers between the users (patients) of the service, and the providers (doctors). People dealing with people is always the best way. Keep a safety net so that catastrophic injuries and illnesses don't destroy people and families, but bring the medical "gods" closer to the people that they serve.
Which health care Insurance Company goes to court to stop Big Coal from poisoning our air or Big Oil from poisoning our water of Big Agra from poisoning our food or Big Pharma from making our meds unaffordable? Only Single Payer would.
Big Insurance needs Big Coal, Big Agri, and Big Pharma to poison as many people as possible to increase their profits as obscenely high as possible. Single payer is deemed a "threat" to all 4.
Forum suggestion:
I have recently noticed a poster of a couple days standing that seems immature and is a distracting factor to the generally civil level of discourse here. I am not disagreeing with all of ActionJackson62 posts merely HOW he is going about his self expression. He has every right to be here and to say what he wishes but if you are incensed with his posts your time is probably best spent ignoring them. The general pattern is AJ: post a comment that is a poorly worded and phrased re-hash of prior comments, with lots of 'shouting cap's' thrown in. XX: discuss or hold AJ accountable for comments, thus engaging him. AJ: rant, rave, shout, name call, stand on AJ's rights without respecting others, distract, distract, distract XX: re- engage, re- explain, get sidetracked etc.
Long standing posters can all site examples of this pattern that self-extinguished by ignoring the posters. I think we're at this point with ActionJackson62.
Single payer or even government option has no positive or negative correlation with single payer or nationalization of health care in general.
Choosing between various corporate insurers simply has no bearing on how much choice one has over physicians, and the profit motive reduces both the patients' and the doctors' choice over treatments.
Personally, I believe that Health, Education and open government go further to make us safe and secure than all the money we're wasting on WARs and the military. We do NOT need "defense" bases in most of the countries of the world to make us "safe".
This is _supposed_ to be a DEMOCRACY, not an EMPIRE.
"Is health any less central to our lives than defense, firefighting, or the interstate highways?"
In many areas the firefighting is done by volunteers, with the equipment and facility funded either the town or by donations (like the volunteer ambulance association of which I was once a member).
Would we dare ask for volunteer doctors in rural areas?