Could we just go to single-payer for health care and be done with it? The goal should be public health not profits…

June 28, 2017

NOTE: All I’ve changed on this post is the headline. But really no matter what, the government has to be involved in health care in order to ensure everyone has it and we all pay one way or another and unless you just say every man and woman for themselves and to heck with poor kids, why not single-payer (government) or socialized medicine? Is it the name that bothers people?

 


 

 

You know, ultimately single-payer healthcare, that is where the government pays for everything, might just be the way to go. Yup, what was once labeled “socialized medicine” or maybe “communism”.

I mean how else are we going to make sure everyone gets healthcare? (that is if we care if everyone gets healthcare.)

And let me go back, I did not mean we should go communist. But that pejorative was once tagged on anything conservatives opposed. Since the Soviet Union, the first nation to ever try communism, no longer exists, and since most of the few remaining communist regimes have resorted to at least some capitalism, socialism has replaced communism (which itself is a form of socialism) as the common pejorative used to oppose anything that does not please über conservatives.

So anyway, former president Barack Obama tried to come up with a way to provide health care to all via the Affordable Care Act, commonly known as Obamacare. I don’t know what his original intention was but it became a compromise between socialized medicine and the capitalist form of private insurance.

But the conservatives, especially the more modern reactionary no-compromise variety, it seems to me were nervous it might actually work and from the start fought it tooth and nail and spread what might be a big lie that it was a disaster. For sure, there were problems. And for sure health care costs have continued to go up. And for sure, still, not everyone is covered.

But I don’t intend to go into all the detail and complexity of the issue, except to note that it is indeed complex. There are a lot of players: the health insurance industry, the medical practitioners, the hospitals and other providers, drug companies, health care workers, and maybe many more.

Not everyone wants the same thing.

But here’s the deal. The goal of the lawmakers and the president should not be to satisfy the various special interest groups but instead to provide health care for all but in an efficient manner that can be economically sustained of course.

We are told that other Western style democracies seemed to have figured out how to do this but for some reason the United States is unique and therefore cannot just copy them.

Single-payer would be costly for the government no doubt. But all methods are costly and we citizens end up paying one way or the other.

It has often been easier, and maybe still is, for the indigent to get medical care than many so-called working poor or even lower middle class, who may not have access to a traditional employer-sponsored group plan, but who do not qualify for government help. But even with that those same people pay for health care for others through their taxes and the costs incurred by an inefficient system that are passed on to them by way of fees.

Also, people with group plans or even purely private plans have had to pay for care for those who could not afford care by way of taxes and the burden on the system that results in higher costs for everyone.

And all I am trying to say here is that in a responsible, civil, and humanitarian society we will continue to make sure that people don’t go without health care, even with the costs it entails.

I heard Kentucky Senator Rand Paul (a Republican with libertarian leanings) say that he thought both Republicans and Democrats want the same thing, basically universal health care or access to health care for all, but disagree on how to get there. And I did of course paraphrase what he said. It seems he is certainly right and in fact within the Republican Party, who has complete control of both houses of congress, there is quite a split.

It’s been said often that the Republicans never did have something workable to replace Obamacare, and now they seem to be caught in a trap of  their own making.

One idea Republicans often promote is health-savings accounts. The idea is that people could then decide to put money back tax free as kind of their own self-insurance. Not a bad idea really, at least conceptually, except if you had enough money to fund an adequate self-insurance fund, you would not need the tax-free savings account, it would seem. Such savings accounts might be adequate for normal medical expenses such as doctor visits perhaps — even then, though, it would seem they might eat up a major portion of the average person’s salary.

I have heard the argument for taking private insurance companies out of the picture, that they just add a layer of bureaucracy and expense. Hmmm, I wonder. Not sure. Unfortunately there will always be a bureaucracy, private or public. We might have more control over a private bureaucracy via the free market. But I am not at all sure about that.

I personally am at that stage in life where I am covered by Social Security under Medicare and I pay for a private supplement. I had employer-subsidized plans in the past and nothing in the way, way past.

I do think it is probably best that all people be required to have insurance, as is the case when you drive a car. It is not practical or fair that someone goes along and pays nothing but then expects to be covered and get top care or care at all, while others act responsibly and pay their premiums. Supposedly if everyone paid premiums the costs would go down or be controlled (would they?).

But at the same time it is wrong to force people to pay for something they cannot reasonably afford.

Having the marketplace determine the cost of health care also seems problematic to me. Personal health care is not something easily worked into a free market. You cannot know exactly when you will need it or what type of coverage you might end up needing and when. And you can hardly force private entities to take a risk that they know is not wise — such as covering people no matter what their likelihood of getting ill or their existing medical history, unless you subsidize the risk taker. A single-payer government insurance or health coverage would not have that worry. It’s concern would be helping people, not making profit. But of course it still has to be paid for somehow, and the marketplace does offer some efficiencies.

So the conundrum: private or public. We tried a blend and may have not given it a chance.

But as far as I am concerned, we should kick the special interests out of the congressional halls, kind of like Jesus kicked the money changers out of the Temple (and I will surely be corrected on that one).

What is good for the people is the important thing.

p.s.

The irony of ironies in the current stalemate on healthcare is that many of the Republican lawmakers who have pushed so hard to repeal Obamacare have found that their own voters depend upon it or something like it. Ooops.

ANOTHER AFTER THOUGHT: Even in Democratic Party-dominated California where both the legislature and the governor’s office are in the party’s hands, single-payer healthcare is being stymied. Maybe the will for universal care is just not there yet, but unless the Republicans at the national level come up with an alternative, I think it one day, not so very long into the future, will be.

 

 

 

 

 

 

 

 

 

 

 

 

 

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A Trump admirer extolls the virtues of China and socialized medicine…

March 16, 2017

So this self-identified Donald Trump admirer was letting me in on the secret to why he got nearly free medical care in China, where he has a wife. In fact, he said he married his doctor. No that is not the secret he was talking about. The secret to great and affordable medical care in China is:

“socialized medicine”.

Gee I thought that was anathema to Trump and his Republican Party (well actually I don’t think Trump is tied to anything, but he’s playing Republican these days).

We were not really talking politics and I don’t know the man’s actual political persuasion, if indeed he has any. He came across as just a regular old Vietnam veteran, trucker/beekeeper white guy who believes everyone ought to work and that there should be no welfare.

He was extolling the virtues of the Chinese system — this self-described Trump admirer. I said very little, just interjected a couple of questions. I noted that China is identified as a “communist” nation. His answer was he was not sure how they work all that out. I allowed that I understood that while China has a communist government it has turned to partial capitalism in its economy.

I don’t know how much of all this was for real but without knowing anything else I will assume he was describing himself accurately (I have no reason to think otherwise).

He said that he has a bee business and that these days his children run it. He also said he was a pilot and he bemoaned the pollution in California. You fly over the mountains into California, he said, and you see a blanket of pollution over the land.

I thought Trump was not big on pollution control — he is trying to dismantle the EPA or at least make it weak.

The man expressed puzzlement over the notion that China has a pollution problem. He said he spends a lot of time there and has not seen it. I would not know myself. All I know is what I see on the internet. I know there was much news that they had to shut down their industry in and around Beijing, the capital, during the Olympics several years ago.

Oh, and I thought Trump has been complaining that China is doing us wrong in trade, taking advantage of us. And what this man said did not necessarily belie that, but it was curious. He claimed that the Chinese “love” Trump because — I guess he was saying that Trump will free up our business and the Chinese love to do business with us.

The man said that he actually ships honey to China for processing. “Everyone (in the bee business) is doing that”, he said. He said that China is the biggest customer for honey.

And China, according to him, is some kind of peaceful paradise. He claimed there is no crime in China. He said you could leave your wallet on a table in a bar and no one would steal it. And if a Chinese policeman tells you to stop, you either stop or you get shot. He said that is what should be done here in the USA.

But one of his main points is that in China everyone works. He did not say how that comes about (and actually I think I have read different — but my knowledge of China is admittedly scant).

So this could be all bunkum or it could be exaggerated or it could be just one man’s limited vision or maybe China is just a paradise and we should all wish we were Chinese (and maybe someone reading this is).

And of course I’m talking about the big China — the People’s Republic (communist), not Taiwan.

Is there a point here? Well my point is that while many of us non-Trump admirers and open-minded and politically informed people see the world a little different from maybe your average Trump supporter, some of us (I hope not me) tend to put people into boxes.

I mean it’s interesting, you can have someone who admires Trump and who is by what I could make out a self-made man and a communist-fighting Vietnam vet to boot, who thinks a communist country is on to something.

I mean they have solved the health care problem:

They have socialized medicine.

p.s.

One thing I wanted to write here was that some people don’t fit into boxes, but rather pick and choose the elements in life that work for them, with an eye toward the practical (practical for them).

Oh, and about cops shooting people. Dead men can’t rob you.

And I think things are a little more complex than all that. But for all my “thinking”  I know that Donald Trump and the man I talked to (as far as I can gather) are far better off than I (financially anyway).

 

 


Hard to support a health care plan that is a “work in progress”…

July 21, 2009

Seems to me all this polling about how many voters support health care reform and how many don’t is skewed in that there is no coherent or identifiable plan out there.

I guess that’s called “transparency” ; you can see through it all because it’s not there.

Health and Human Services Secretary Kathleen Selbelius just said in a short interview on FOX News that there is no “it” (meaning plan), that it is a “work in progress”.

Kind of hard to answer the question whether you support a plan that is still in progress.

Nonetheless Fox glibly reads off the numbers – 50 percent approve of the Democrats’ or president’s plan and 40 disapprove (I guess 10 percent have no opinion – wise people since there is no one plan to have an opinion on). And maybe I got the numbers reversed, because in double checking what I thought I heard,  I found that on the Gallup Poll site for today it says 50 percent of those polled dissapprove of the president’s handling of the health care issue and 44 percent approve. And I suppose if you do not even know any details, you probably would be forced to be dubious of the whole thing.

I like how FOX News likes to play the devil’s advocate with its chums on the right. When a Republican congressman was lambasting the liberal Democrats for bloating the budget, the FOX host pretended to corner him by asking: “where were you when Bush passed all those spending bills and ran up the deficit?” (okay, not really the exact quote, but a good paraphrase).

I fell for it. I thought “ah hah!, got you there Mr. Two Face”. But the seemingly hard question was just a set up. The congressman answered that he voted no all the time and warned Bush that he was running up the deficit. Well some Republicans must have voted yes, especially for those many years that Bush had the majority in both houses.

(Despite its tag line, FOX is neither fair nor balanced in its coverage, but it is entertaining at times and it does in a way serve as a check on, say, CNN or MSNBC, but while the latter may at times seem to lean one way, the former is just one way. The problem is most of the news on cable is mixed with opinion, so you seldom if ever get the straight story.) 

Not much of a segue here – but even though some think partisan politics is a bad thing, at least if practiced correctly it might get something done. I thought the purpose of political parties was to form ideas around a set of beliefs and coalesce everything into proposed legislation.

But in American politics with our separation of powers, particularly between the legislative branch and the executive, and our emphasis on individual candidates and personalities and the power of special interests (via lobbyists and their money donations), parties are not effective as they are in nations that have a parliamentary form of government.

And that is why President Obama is apparently having such a hard time passing health care reform legislation. Even though he has a super majority in the congress, not everyone in his party is behind him and to make matters worse he does not even have his own plan that can be identified and studied.

I almost think he would have had a better chance of just pushing his own plan and calling it “socialized medicine” and proclaiming that it is the only way to guarantee health coverage to all and at the same time get a handle on costs.

Social Security is a sacred cow, so why couldn’t he just call it Social Health Security?

And now I hear one pundit say something to the effect that if we try to cover everyone the doctors will not be able to handle it so therefore we will have rationing. So I take it that he would prefer we not offer health care to everyone. (ADD 1: I realize now that was the creepy, but ever political insightful, Dick Morris.)

President Obama seems to be on the ropes with his health care reform initiative, but for all I know he knows what he is doing and will prevail. But from what I can gather it seems more likely that some type of Band Aid measure may make it through and although it will not really help, Obama will be forced to declare victory and move on.

I just happened to be listening to cable news gabbing when I should have been doing something more productive and felt compelled to get some observations down.

P.s.

I heard more on this current story of a woman in Canada who said through the government health care there she was put on hold for a life-saving procedure and wound up coming to the United States. She had to mortgage her house, I understand, but at least she got treated. She said that after getting some info from the U.S. she tried to go back to Canada on the U.S. doctors’ advice to get what she needed done via the system there because it would be cheaper. But she still ran into a brick wall there and got her procedure done in the U.S. after all. She also claimed that Canadians often do not admit that they get a lot of health care in the U.S. while claiming they have such a good health care system at home. I personally have no idea if this is all true or whether she is leaving something out. The bottom line is if you have the money, you can get medical care somewhere. The problem is so many of us do not have the fortune required to get medical care that we need. Sometimes I think not enough is said as to why medical care costs so much. I understand the cost of advanced technology and the fact that professionals will always demand high remuneration and the cost of research for drugs. Even so, are there not limits?