Posts Tagged ‘Healthcare Reform’

What if it were terrorists at the school?

December 17th, 2012

Newtown's AngelsAs a nation, we mourn for the losses in the senseless Newtown, Connecticut school rampage last week. In the wake of that horrible tragedy we’ve seen many calls for action—calls for improved mental health services and screenings; calls for re-instituting the assault weapons ban; calls to change our culture of glorifying violence; and even calls like President Obama made last night to just do something to make this better.

On the flip side have been many voices shouting that this is not the time for discussion of solutions. They try to counsel that there is simply evil in the world and there’s nothing to be done about it beyond the coping, the grief, and the prayers that such things don’t happen again.

But I can’t escape the glaring hypocrisy of the position that now is not the time to act. Consider for a moment what those same voices would be saying if a Muslim terrorist cell had raided that school and killed those children instead of a local white man.

As a country we have been all too eager to spend money and lives as well as sacrifice all manner of personal freedoms in the interest of keeping our families safe from the statistically small threat of foreign terrorism. And we sacrifice these things in almost knee-jerk reaction to events or near-events—consider 9-11, the underwear bomber, etc. We’ll let the government screen our calls and read our emails. We’ll let them illegally and indefinitely detain suspects, and perform so-called “renditions”. We’ll let them use torture as an interrogation technique. We’ll let them grope our wives and daughters prior to boarding a plane.  But hey, better safe than sorry, right?

But should the government want to provide medical services or restrict the ability for your neighbor to grocery shop while packing a semi-automatic pistol with a high capacity clip? Well, let’s not get crazy here. After all, this was just a troubled kid who went off the deep end. Shit happens.

But if that troubled kid looked Pakistani instead of like the guy next door? Well, shit would happen then too, but it would be different shit. And we wouldn’t be arguing about whether or not to act. This is America dammit. And overreaction to a threat is what we do best.

 

The Real Obamacare “Tax”

June 29th, 2012

Ackbar

“It’s a TAX!”

I was watching Fox News yesterday as the SCOTUS ruling upholding Obamacare’s individual mandate came to light.  Commentary was all over the map for the first 30 minutes, but then began to rapidly zero-in on the accusation that this was now a tax on the middle-class. They had found their message, and from then on sang out in perfect harmony. It was kind of amazing.

“(Americans will) like it even less when they understand it’s a tax,” Sen. Mike Lee, R-Utah, told Fox News.

One curious element is that nothing related to the mandate is different today than it was last week—excepting the label. The notion that people’s view of the mandate will change as a result of a renaming is a blatant play to the ignorance of the audience.

Still, even if we accept the new label of “tax”, is it really a new financial burden on the middle class as conservatives are saying?

For those who are currently uninsured and financially able to afford healthcare, Obamacare will impose a new financial drain. Although, in return they get health insurance. We can call that a tax if you like.

But on the flip side, those who are currently insured are presently picking up the tab for the uninsured through higher insurance premiums and medical costs. Getting the uninsured into the pool lowers policy rates for the rest of us. This is even more true as other popular provisions of Obamacare, such as preventing coverage denial for pre-existing conditions, comes into force. The net result of this is a lowering of the financial burden on the currently insured, which is a significant majority of citizens.

If forcing the uninsured into the pool is a tax increase, then it only seems fair the reduced costs to the insured be considered a tax cut.  At worst, this is a wash. At best, the tax cuts for the majority will significantly outweigh the tax increase to the minority.

Will there be individuals who will pay more as a result of Obamacare? Sure. But many more of us will pay less. So it’s pretty hard to argue in aggregate that this is a tax increase on the middle class.

The Mythical War on Religion

February 1st, 2012

I Want You to Pay for AbortionsReligion is under attack in America—at least this is part of the ongoing narrative from the far right.  It fits with the themes that Obama in particular and liberals in general are out to destroy the foundational institutions of the country.

It is in the context of this narrative that Michelle Malkin gets her panties all in a bunch over the new Health and Human Services directive that all employers must abide by federal guidelines to include legal contraception as part of their employee medical insurance, including employers such as church run hospitals, schools, and universities. (The churches themselves are still excluded)

Somehow, this translates to a government mandate that churches have to pay for abortions.  Bishop Paul Loverde didn’t mince words when he called the U.S. Department Health and Human Services order “a direct attack against religious liberty. This ill-considered policy comprises a truly radical break with the liberties that have underpinned our nation since its founding.”

Before I call “bullshit”, let me connect the dots.  Since the late 90’s, legal contraception has included Plan B or the morning after pill.  If you’re of a mind to view an unimplanted fertilized egg as a baby, then this becomes abortion.  So do a lot of other things, but that’s not important right now.  Further, strict Catholic doctrine holds that contraceptives of any kind are not allowed.  Hence the claim that the HHS directive is an attack on religious liberty.  Oh, and the HHS is part of the executive branch of government, so this is an order by Obama, who is evil and out to destroy us, one baby at a time.

Ok, all together now… “Bullshit!”

It is this sort of conflation that gives Conservatives the reputation of snake oil salesmen.  There are arguments to be had here, but this ain’t one of them.  For example, you might reasonably argue:

  • Plan B should not be a legal contraceptive
  • HHS should not require contraceptives to be covered by employee medical insurance
  • The government should make no regulations on medical insurance

Fine.  Have those battles.  (Actually we did have those battles, that’s how we got here.)  But recognize, the actual argument being made is that religious run organizations are exempt from following the law in cases where they disagree with it.  It’s wrapped in the cloak of religious freedom because that issue gets people not really paying attention (and that’s a scary big bunch of them) all in a tizzy.  The larger point gets muddled because the word “abortion” is tossed around, and everyone loses their frickin’ mind.

But suppose the fictional Church of Bob declares that all girls be deflowered by the minister upon reaching menarche.  Pretty clearly no sane person would advocate that the church get a child abuse waiver because it’s part of their doctrine.  What if the Gospel according to Bob dictates that no followers will pay taxes, or no followers will enter the military?

The point being that in this country, it doesn’t matter (or at least it’s not supposed to matter) who you are or what group you belong to.  The law is the law.  Follow it or pay the consequences.  Work to get it overturned.  But are we really going to sit by and argue that any person or group should be exempt from any law because they don’t agree with it?

Try that the next time a cop pulls you over. “Gee Officer, you see… the thing is… I don’t believe in speed limits.”  If that doesn’t work, try claiming that speed limits cause abortions.

 

American Exceptionalism: Dying with our boots on

December 30th, 2011

American ExceptionalismThis is America dammit, and it is the greatest best country God has ever given man on the face of this Earth.  You can either agree with that, or we will kick your ignorant ass to the curb.

This has been the mantra of the right-wing of American politics for a few decades now, but in varying degrees it reflects the view of a much broader swath of us.  Post-WWII America has enjoyed a prolonged period of global dominance from military might and technological prowess to economic clout and cultural influence.  We were the Jones everyone else was trying to keep up with, and still are, albeit to a reduced degree.

Maybe we’ve earned our arrogance, but that doesn’t lessen the reality that we are, in fact, arrogant.  And with that arrogance has come the belief that no one else on the planet has a thing to teach us.  We are not only reluctant to learn from others, we are adamantly opposed to entertaining proven solutions that are not homegrown.  More so, if those solutions fly in the face of truths we hold to be self-evident—data be damned.

I’ve written in this space before about how single-payer and/or single provider healthcare systems employed in vast majority of OCED countries provide comparable healthcare to their citizens at half the cost of U.S. programs.  Yet we are not remotely entertaining any such options because they are deemed “socialist” and un-American.  Socialized medicine lies in opposition to our belief that government is always the problem and never the solution.  This in spite of the success of Medicare and the VA healthcare programs, each of which is completely socialized and also very popular.  Not to mention a widespread acknowledgement that healthcare is one of the most daunting economic and social challenges in our immediate future.

Now comes evidence that we are again sticking our heads in the sand (or other dark place of your imagination’s choosing) when it comes to education.  Finland has turned in over a decade of consistent top tier performance amongst OCED countries.  Meanwhile, American students rank in the middle of the pack, despite spending about the same per-capita as the Finns.

It turns out, the Finnish model is based on equality of opportunity rather than competition.  There are no private schools in Finland, and all the public schools get uniform funding and supplies, regardless of neighborhood.  There are no standardized tests (excepting a graduation exam), but there are standardized expectations on both teachers and students.  Teaching in Finland is a high competition profession, and teachers are recruited, paid, and viewed as high-end professionals.  Finnish schools assign less homework and engage children in more creative play.  It is a place where the main driver of education policy is not competition between teachers and between schools, but cooperation.

Americans recognize we need to fix our educational system.  We even recognize the Finns might be doing something right, and repeatedly invite them to consult with us… on how to improve our tests and better incentivize teachers and schools toward high achievement.  In other words, we’re all ears as long as what you want to say to us is that we need to do just what we’ve been doing, but with more gusto.

In truth, the educational trends in the U.S. could not be more un-Finnish.  Eliminate the Department of Education and decentralize schools.  Provide school vouchers for increased competition from private schools.  Issue more standardized tests, and defund schools not living up to performance standards.  Yet, we cling to these policies because they reflect the American values of capitalism, competition, and more stick, less carrot.

As President Bush asked so eloquently, “Is our children learning?”  In a word, “No.”  But then neither are the adults.  But at least the adults take a perverse pride in their ignorance.  We’re #1, and we want that inscribed on the headstone—data be damned.

The budget problems are all healthcare related

July 29th, 2011

Fix ItHealthcare spending in the U.S. accounts for 17.6% of the economy, and is projected to be 20% by the end of this decade.  These are not federal budget numbers, this is the whole economy.  $1 out of every $6 that’s spent in this country is spent on healthcare.

For context, that’s double the percentage spent in the average OCED country.  In absolute dollars, we spend 2.5 times more per capita than average, at $8,650/person.  And for all that money, we rank just under the average for life expectancy and infant mortality.

This is a pointless drag on the entire economy.  Not only for the government and private employers, but for workers as well.  One of the reasons wages have been so flat for the last decade is that money available for employee raises has gone into preserving medical coverage rather than increasing take home pay.

Yet this is also a big issue, perhaps the only issue, for the current budget problems faced by the federal government.  Government spending on healthcare (including employee plans, veterans benefits, as well as Medicare and Medicaid) is $1.17 trillion each year.  And this is projected to double over the decade.  Granted, these numbers are inclusive of state and local government spending as well, but this is still paid for with our tax dollars.

In other words, considering our 2.5x cost premium, there’s $700 billion/year sitting on the table if we manage to get our healthcare costs in line with our global peers.  Even assuming the federal portion is only half of that, the numbers dwarf any of the cost savings currently proposed by either party’s budget plans.  Couple this with the already planned savings for drawing down the wars, and our deficit goes away by 2020.

This is the only budget problem we need to be addressing.  It saves Medicare, Medicaid, Social Security, NASA, Pell Grants, and everyone else currently on the chopping block.  Do the math.

So why aren’t we focused on fixing this?  Primarily because the proven method of achieving the healthcare cost goals, the one used by pretty much every other OCED country we are benchmarking against, is some form of single-payer model.  And for reasons known mostly to powerful corporate lobbies for insurance, pharmaceutical, and medical device  companies, single-payer health plans are socialist Nazi plots to kill Grandma. Instead, we are committed to responsible prudent austerity founded on shared sacrifice… because Grandma prefers be bankrupt such that she is forced to choose between food and medicine.  After all, it is about having a choice.