The Health Care Bill

Things have been busy at work the past couple weeks (the car makers must be making up for last year!) and I've hardly had any time to put my two-cents in over of MMFA lately. (Which is a good thing: in this economy, and in Michigan of all places, I'd rather have too little time on my hands than too much! LOL) So I was really rushed in this thread, so I wanted to come back and put my piece on the table regarding the pending health care legislation...

...and I don't suppose too many people, on either side of the issue, will like what I have to say about it. So let put a few "givens" out there, right up front.

1) I HATE insurance companies.  We all know the multitude of ways that they screw people over, and I'm no different. My story?  My two sons have autism.  The insurance company paid for the diagnosis, but the minute they "autism" label was stuck on them, they wouldn't pay for shit in terms of therapy. (I came across THIS once, and it really hit home.) You know... Cause they don't get any better.  (1) First of all: tell that to Temple Grandin.  (2) Second of all, neither do AIDS patients or Diabetics or Schizophrenics or Transplant Patients or a million other patients who are on medication or medical therapy for life.  But we all know that they'll throw any bullshit they can at you just to get out of paying.  It doesn't have to be logical, scientifically correct or even make sense.  They hold all the cards, so you're at their mercy.

So if anyone things I'm in the pocket of the insurance industry, I dare you to say it my face.  (And I'd then advise you to them DUCK.) I HATE. HATE. HATE. those scum-sucking bastards.  They turned their backs on my kids.  So fuck 'em.

2) The Right, the Conservatives, The Republicans, the Insurance Lobby and Fox have all told so many lies about this whole issue, that I really don't even care what they have to say anymore. (I never really did, but it's less than background noise now.)  They're so far out in Right Field it's not even funny anymore. It's pathetic and sad.  Death Panels? Lie of the year.  Deficits? Lie of the day, just depends on the issue you're discussing.  Government Takeover? I only WISH.  And I swear I'm going to punch the next person I hear crying about "socialism."  So this in not, in any way, intended to argue with the idiots on the Right.  90% of them have no fucking idea what they're talking about, and the other 10% are lying for their paychecks.  And even if every concession was given to them (and it basically has) they'd oppose it even if their own mother's life depended on it, just to see Obama and the Democrats "lose."  They're despicable bastards without heart, soul or brains.  So I'm done with them.

I want to take issue with the LIBERALS, who at this point are ready to jump ship on it.


Now... don't get me wrong.  IMHO, the only PRINCIPLED, EDUCATED opposition to this bill, and anything in it has come from the Left.  And I've laid out my own plan, which is about as close as you can get to single-payer, and yet not have the gov't run it, and still use market forces to keep costs DOWN, rather than UP as they do now.  So you know I'm no libertarian when it comes to this issue.  All that being said, in my humble opinion...

THIS IS IMPORTANT LEGISLATION.  THIS IS GOOD LEGISLATION. AND THIS COUNTRY NEEDS IT TO PASS. NOW.

I can't remember where I read it (and it may have been in this blog, so please forgive me if it was you and I forgot) but I recently read where someone call Health Care Reform the "New Deal" of our generation, and went on to call Gay Rights the "Civil Rights Movement" of our generation.  I absolutely agree, 100% with that analogy, and that is exactly what drives my thinking here:  The New Deal was not a single piece of legislation.  Neither was 'Civil Rights.'  Both represented sweeping changes in HOW WE THINK.  They represented paradigm shifts in out whole legal, economic, political and social philosophy.  They both occurred over MANY bills, MANY laws, and even MANY court cases, both in support of and in opposition to. And there was no point at which ANY single piece of legislation SOLVED THE PROBLEM. (We still have both economic instability and racial issues today, after all, and we probably will 100 years from now.)  So you could take ANY piece of legislation, in either of those two cases - the first, the last or any in between - and find some fault with it.  It doesn't go far enough.  It makes too many concessions.  It makes things worse.  But just as well, in each case, each step had to be taken, as it was, because at each stage they had to take what they could get and keep moving forward.

And that's where I part with the idealists on the Left: I'm a pragmatist.  Do I agree with Michael Moore, and Keith Olbermann and Dennis Kuccinich?  In principal? Yes.  But in practice, I do not accept the conclusion that this bill makes things worse.

Will the insurance companies profit from this? Yes, I'm sure they'll find a way to. They always do.
(I don't mind that they make a profit. What bothers me is that the currently profit more by denying care. That's the dysfunctional incentive.)

Will some people remain uncovered? Yep.  A good 20 Million as I understand it.
(That's still half what it is now, however.)

Do I like the individual mandate? Not without a public option I don't.
(But whether or not it's constitutional, is a matter for the courts to decide, not a reason to oppose it.)

BUT...  I also see this bill as a NECESSARY first step.  We'd all like single-payer.  Wasn't going to happen. Personally, I prefer MY PLAN.  Not going to happen. (Wasn't even on the table. LOL)  Public Option? Might have happened, if Harry Reid had any balls, Nancy Pelosi was worth a damn and President Obama wasn't the pragmatist that I figured him for when I voted for him, despite the Right's attempts to brand his as the most moon-bat liberal homo-sapient of all time.  And while I'd certainly have have liked it, maybe even participated in it, I can live without it, even with the individual mandate.

Why?

Pre-existing conditions.  If you want to force them to cover pre-exsisting conditions, (and we need to, with everyone switching jobs, getting laid off, etc...) and not let them totally jack up the premiums to cover them, and you DON'T want your costs to skyrocket, the only way to achieve that is to have EVERYONE pay-in.  You need healthy people who right now, whether by choice or by circumstance, aren't putting in to ante up and get covered.  And to all you wanna-be micro-economics majors out there, this is yet another instance where market forces work in strange ways.  You see... It doesn't cost more to COVER more people.  COVERING PEOPLE is a source of REVENUE.  The increased demand for coverage does not necessarily lead to higher costs.  What increases costs is more (and more expensive) CLAIMS being filed.  Does universal coverage lead to more, and more expensive, claims?  On average, per person, not really.

Remember - this gets a lot of currently HEALTHY people on board.  That will only LOWER the [insurance company's] cost, on a per person basis.  And all those uninsured SICK people?  As I laid out in my earlier health care posts, right now they wait until their on death's door and then show up in the ER.  And they then run up HUGE bills, that then don't get paid.  Well, first of all: Guess who pays them? WE DO, though higher premiums, as hospitals try to recoup unpaid bills by soaking insurance companies!  They don't just write it off, and even if they do officially, they still try to recoup it from US - the insured.  Second of all, if these same people were covered, they'd go to the doctor EARLY ON, when [whatever it is that they have] can be fixed CHEAPLY and EASILY, with FEWER COMPLICATIONS and better PATIENT OUTCOMES.  Which is exactly what we WANT THEM TO DO because it COST LESS THAT WAY!  It's ALWAYS costs more, not to mention has more negative outcomes, to treat a disease in the later stages.  It's ALWAYS better, and cheaper, to catch it and treat it EARLY. So the idea that we'll be paying for something that we're not already is misguided, no matter what model you're looking at.

Is this bill perfect? No.  No way.  Is it even good? Debatable, certainly.  But is it NECESSARY?

Yes.  I firmly believe it is.

And to some extent the details don't matter. (And I realize there are some doozies.)  This will not solve all of our problems, but neither would a public option and neither would even single payer.  But about the only idea I've heard that would make it WORSE was John McCain's '08 campaign idea to let people buy across state lines.  THAT, and some of the more "free market" solutions I've heard, would make it WORSE. Much worse. And I just don't believe this bill does.  Not in  any BIG PICTURE kind of way.  It has it's warts, but at this point, and really at any point, we need to take what we can get, celebrate the victory, and move on to the NEXT STEP.  Because whoever succeeds Obama, and whenever that happens, will STILL be dealing with health care.  No matter WHAT happens, or even might have happened with this bill.

I actually, honestly believe that we'll get to single payer eventually (though still I prefer my own model.)  But we're not going to get there in one bill. (Shit, we might not get there in my lifetime!) This will be, and has to be a gradual process.  And the necessary FIRST STEP, really the first two steps, has/have to be:

1) Everyone needs to put it / Nobody is allowed to opt out.  (And help the ones who truly can't afford it.)


2) The insurance companies can't be allowed to refuse anyone, and can't be allowed to gouge anyone.

Now... we're not there yet. But this bill brings us closer.  And we can't get on with the REAL reforms until we've achieved those first two steps.  And come November?  It's likely the Republicans will make some gains, and the already uphill climb will only get steeper.  We need to take what we can.  We need to start moving in the right direction.  We need to get the ball rolling.  And we need to do this as soon as we can.

We NEED this legislation, warts and all.  I don't LIKE it... but I do believe it's necessary.