Health Care Reform Series: Distortions in the public debate on health care

July 4, 4:59 AMLiberal ExaminerJenny Kakasuleff

Previous Next

31 comments Print Email RSS Subscribe

Subscribe

Get alerts when there is a new article from the Liberal Examiner. Read Examiner.com's terms of use.

Email Address   Include other special offers from Examiner.com Terms of Use

Senior White House Adviser Valerie Jarrett walks in to speak about health care during a town hall meeting with President Barack Obama, not shown, Wednesday, July 1, 2009, at the Northern Virginia Community College in Annandale, Va. (AP Photo/Alex Brandon)

In the first section of the Health Care Reform Series, I discussed the history of health care in the U.S., focusing on the evolution of our system, and highlighting the burdens we are now facing. This section will begin with an examination of the public health debate, more specifically, the propaganda that fuels polarization and political gridlock. The final parts will outline the arguments of both opponents and supporters to universal health care.

Read Section 1: A history of health care in the U.S.

For all the intricacies of the health care debate, the central question seems to come down to values and a particular social ethos: do you believe everyone has a “right” to health care, regardless of ability to pay? As mentioned previously, every other industrialized nation in the world answers this question affirmatively, and as a result, they offer health care to all of their citizens.

The Republican Party and affiliates answer this question in the negative. There are a variety of arguments and talking points that have been repeated ad nauseam to terrify the public against the prospect of universal health care. Quite tellingly, the main culprits driving opposition to universal health care are the industries that stand to lose their ability to make wildly obscene profits on the backs of hard-working Americans.

To be fair, their concerns are real. They understand universal health care and that the publicly-funded option which must necessarily accompany it (since private insurers have failed to bring everyone into the market) will be able to better contain costs. After all, publicly-funded programs, like Medicare, do not have an overhead of 30% like private insurers - it’s more like 3% – and 1% in Canada’s single-payer system. Publicly-funded programs do not answer to shareholders, or strive to earn a profit, so the multi-millionaire dollar bonuses doled out to CEO’s and corporate executives would disappear from the exorbitant premiums individuals currently pay.

Indeed, if private industry wanted to continue to exist in health care alongside a public option, it would need to dramatically cut costs and profit-margins to bring premiums in line with the actual cost of health care. For the same reason that Prudential balked on providing health insurance in the 1920’s, private insurers know full well that the healthiest Americans - those who currently subsidize their ability to reap these profits - would find more value in a cheaper alternative.

Since private insurers are not currently required to offer non-discriminatory care, and purposely seek out this healthier demographic; the possibility of growing exponentially would quickly diminish as society transitioned from a health economy that favored profit, to one that actually favored care.

Private insurers should be worried about the prospect of a public option for Americans, as it would push them toward irrelevancy, and if their campaign contributions and lobbies are any indication, they are concerned that the gravy train may soon come to an end. The anti-reformists—as they will herein be called—are perfectly satisfied with the status quo.

Understanding the financial reality of the situation—since it is indeed, untrue that government intervention is to blame for rising health care costs—one of the primary scare tactics used by the anti-reformists is to attack the quality of a universal health care program. If they are unable to win the game of numbers, perhaps they can convince Americans that the higher premiums will at least get them better care.

They warn Americans of waiting lists in Canada and the U.K. that span months, seriously distorting the reality and making it appear as if there is a serious health crisis in these countries. Studies that have attempted to look at wait times in Canada are inconclusive based on the way that data is collected, and on wide variances between the provinces and regions. At best, opponents rely on anecdotal evidence—self-reports and other exaggerated claims by individuals that are more accurately deemed the “exception, rather than the rule.”

Waiting lists only exist for certain elective procedures—despite horror stories that individuals are dying on a regular basis due to wait times. There are a small minority of Canadian’s who receive health care in the U.S., but the idea that they are jumping the border in droves to receive America’s superior care is a myth. Of the 18,000 individuals responding to a Canadian National Population Health Survey, only 90 reported having received medical services in the U.S.; and only 20 of these reported going to America for the purpose of receiving health care. Others cited being in America for business, vacation, or other reasons.

For any system that provides coverage to 100% of the citizenry, we would expect demand to exceed those nations that do not. However, this does not indicate a systematic flaw—it simply indicates the need for more funding to expand technology and services.

When attempting to demonize every other nation that currently insures its citizens against medical disaster, the claims often fall short of the hype. Faced with this fact, opponents attempt to define universal coverage as welfare, hoping to appeal to those out there who are petrified that someone might be benefitting from a government-run safety-net program somewhere.

Imagine if police and fire were rationed based on your ability to pay; would we even submit to such nonsense? Why isn’t the health of Americans considered as important as their security? In this case particularly, the latter is at least partially dependent upon the former.

Anti-reformists extend the welfare argument in order to portray the uninsured and underinsured as lazy; indeed, deserving of their plight due to their own poor choices. “It is not my obligation to help them,” the argument goes.

The patriots of private industry also purvey the notion of American exceptionalism—the idea that the U.S. holds a “special place in the world,” both morally and economically. Despite the fact that international studies prove time and again that the U.S. does not have “the best health care in the world,” these thinkers are resigned to live beneath their rock of ignorance by continuing to swear that it does. At least republicans acknowledge in the Patient’s Choice Act—addressed in further detail later—that this is absolutely not the case.

Anti-reformists relentlessly attack universal care as “socialism;” playing on the fears of Americans by warning of a massive tax increase and a resulting fascism if such a system were in place. They resurrect images of Nazi Germany and the Soviet Union to plant the subliminal idea in their audiences’ heads that somehow, universal health care would bring down our free society, leading to the possible internment of millions of Americans into labor camps.

They are insistent that patients will be denied choice and limited to government-sponsored physicians. Even though currently, Medicare patients are allowed to choose any physician they prefer—as opposed to private managed-care, which has a limited network of providers—and most providers accept Medicare patients. As one physician stated, “getting paid is easier,” through Medicare than private insurers, who follow a patch-work of different rules that must be followed to receive payment, or do not pay as quickly, and have different exclusions, covered services, and in-network specialists and labs that must be considered before treatment to insure payment.

Opponents ask, “Do we really want an organization that developed the U.S. Tax Code handling something as complex as health care?” When they speak of the mound of red-tape that government-run programs require users to navigate, and the government-bureaucrat making their medical decisions, they should be directing their rage at private industry. Commercial insurers have introduced more inefficiencies to the process than government could ever dream—and it is all designed to DENY medical care—at the expense (literally) of physicians and hospitals; and their patients.

Beyond that, they declare, providing care to all means that everyone is going to use it, and more will abuse it, which will inevitably lead to the rationing of medical services. To the degree that the plan will expand enrollment—since that is the overarching goal—individuals are not suddenly going to begin opting out of otherwise more entertaining activities to harass their doctors without cause—excepting the occasional hypochondriac.

Having foreknowledge of these facts, the most egregious claim is that government intervention is responsible for rising costs—which is clearly untrue—and in addition to Tort Reform, comprises most of the increased cost of insurance premiums. If Medicare and other government-run programs were not caring for the neediest among us, private industry would not be doing it either—as indicated by the emergence of the programs in the first place—the free market failed to provide even near universal coverage.

There are those who agree that it is a problem to have so many in the country who lack adequate health care—or who are at least willing to pay lip service to it. Most are conservative politicians who have received too many constituent complaints to deny any longer that a problem exists. As a result, they have shifted their focus to providing market-based solutions to the health care crisis.

The next part will discuss proposals by congressional republicans to retool the current delivery system of health care, particularly with respect to the Patient’s Choice Act, focusing particularly on its ability to produce desired results.

Read: The Patients' Choice Act

Become a Subscriber (link above) to receive notification when the next part of the Health Care Reform Series is published.

*If you would like to submit a health care story, with the possibility of seeing it published here, please send me an email message at jennyk1981@gmail.com.

Copyright ©2009 Jenny Kakasuleff