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    Another Smart Guy in DC figures out Healthcare is Expensive

    In an article linked to on the TPM front page, yet another oh so smart guy, Jonathan Cohn, writing in The New Republic amazingly reveals his insightful discovery in a piece titled "The Single Biggest Issue that Could Undermine Reform". http://blogs.tnr.com/tnr/blogs/the_treatment/archive/2009/04/01/the-single-biggest-issue-that-could-undermine-reform.aspx  Along with everyone else I'm sure; I was shocked to learn the single biggest issue that could undermine health reform is... money!  Wow!  Ya think?

    The author points out how expensive it will be to have "reform" in the general sense that our cowardly political leaders are comfortable discussing it.  Naturally, any program of subsidizing the parasitic health insurance industry in order to get more (not all, just more) people covered by the rotten system we have now while maintaining the precarious and inexcusably expensive employer based health insurance racket most working people rely on, is going to be damned expensive.  That should not be considered news. 

    Cohn also reveals that Obama has not proposed how to fully pay for this pig in a poke proposal he has made though he vows to "work with Congress" on finding the rest of the money at some undefined future point in time.  Cohn ends the article with hands raised and shoulders shrugged like most of the smart guys in the mainstream and inside the beltway.  He doesn't see how reform gets done and offers no possibilities of how to do it.  In some ways I don't blame him.  Why should he waste his time?  After all, even if what the President proposes actually gets passed, all it does is provide subsidies for insurance companies to keep sucking the lifeblood out of premium payers and our economy.  It's not reform, it's a shell game.  At best, the President's proposal would serve as a band aid and an excuse for those who don't want to do what is obviously necessary which is to assign our current system to the ash heap of history, and subordinate it to a supplementary role in a new, single payer health care system.  Such a model would replicate the superior models we find in all the industrialized nations of the west.  If the band aid is passed, it will only delay the inevitable and give aid and comfort to the very interests that continue to grow rich by sucking money out of productive society to keep their bottom lines fat and bloated.

    Yes, obviously, changing our health care system and then paying for it is going to cost money.  But since our current situation is the most expensive on earth and does not produce outcomes comparable to the allegedly "inferior" systems elsewhere what the hell are we waiting for?  The only practical solution to our health care crisis is a single payer system of some kind.  Everyone knows that if they are honest about it.  It's the only way to cover everyone and it's the cheapest alternative and it will provide better outcomes because it will be health based instead of profit based.

    Yes, the insurance industry and other vested interests will oppose it.  This is a given.  But for crying out loud, are we to accept cowardice as an excuse for not doing anything about any of our major problems?  I think it's time to let our "leaders" who seem to all be chickenshits that they need to start doing their jobs which is representing the interests of the people who elected them instead of the people who wine and dine them.

    But, back to Mr. Cohn's revelation.  Where is the money going to come from?  Well for one thing, if we'd quit fooling around with these dumbass subsidy plans that won't improve anything for anyone in the long run and go for single payer, there will be substantial funds available in the form of all the trillions of dollars that go for paying the premiums to the health insurance parasites right now since people wouldn't need to be paying off those bloodsuckers anymore.  In all probability, both employers and employees could pay less than they pay now and get more health care as a result.  For another thing, if we start taking a look at the waste, fraud, and abuse that is available to cut in the federal budget and we don't exempt anything we could probably find on the order of $300-$500 Billion annually by cutting out all the obscene and unnecessary, wasteful contracts and programs for instruments of war upon which we waste grotesque amounts.  We spend more on defense annually than all the other nations on earth combined.  Last year, without the two wars we're talking about $650 Billion for "defense" and we all know it isn't because it is needed it is because the legendary Military Industrial Complex is an insatiable and malignant cancer on our nation that instead of protecting us drains the very lifeblood from America and robs our future of enormous possibilities including peace and prosperity.

    So, if you need the cheapest and best "reform" it's clear that some form of the Medicare for All bill sponsored by Rep. John Conyers is the route to take.  It provides the best coverage for all our citizens--not some---ALL our citizens for much less than our current system costs and will improve the health of the nation dramatically.  And if you need money to pay for it there ought to be plenty to be found in the private sector that would, under single payer, be freed up and available to be rerouted to pay for the new single payer plan instead of paying for premiums to keep the parasites fat sucking off of the productive members of society.  Combine that windfall of money with massive cuts in our obscene and utterly unjustified "defense" budget and there's more than enough money to pay for making sure all Americans have what every citizen takes for granted in all the other industrialized nations on earth and have for years: knowing that when they get sick they can get the medical care they need because they need, not because they can pay for it out of their own pocket.

    When I see the nation's smart guys like Cohn going round and round in circles about how to do this healthcare thing but being so blinded by the wedded bliss they experience as part of the status quo, it makes me wonder why anybody thinks these smart guys are so damn smart.  And of course, in my foolishness I start thinking that I see the same sort of limited vision, bad judgment and defense of the status quo everywhere I look in our society whether it is the financial sector disaster and handout, er, I mean "bailout" or the coddling of the interests of big oil at the expense of our environment, or just about anything else you can think of.  And then in my foolishness I start to conclude that maybe what we need is to flush our society altogether, top to bottom of the atrophied thinking and leadership that has led us to so many disasters they are now asking us foolish little people to pay for.  Our economic, political, civic, and media elites with precious few exceptions have utterly and completely discredited themselves.  Their incompetence, failures, irresponsibility, and disasters appear to know no bounds.  I know I'm not one of the smart guys in DC but seems to me it's high time that we got a new New Deal that radically redistributes power and wealth in this society if we hope ever to see improvement on any of the major issues the nation faces.  But you won't read about that in the New Republic or any other established organ of the status quo even if it claims to be "liberal". 

    I think it is time Americans started thinking along the radical lines of Martin Luther King with respect to how this society works and how we both want it to work and how we must have it work if we are actually a nation that values justice, fairness, equality before the law, peace and prosperity.  See this link for a reminder of what King was really all about:  http://tpmcafe.talkingpointsmemo.com/2009/03/31/remembering_and_misremembering_king/index.php#comment-3426293

     

    Comments

    They aren't so damned smart, they're just so damned entitled, and so damned entitled not to have their taxes increased. The politicians aren't so damned smart either, but they are for sale.


    It's all about priorities:

    You can have the best healthcare, money can buy. or:

    You can have the best government, money can buy.


    Good point resistance!


    . . . our "leaders" . . . need to start . . . representing the interests of the people who elected them instead of the people who wine and dine them.

    Are you sure they're not representing the voters' interests?

    Most voters are insured through employer plans or Medicare. I suspect they like it just the way it is -- or, giving them the benefit of the doubt, that the vague and possibly very expensive alternative just doesn't float their boats.


    So, if you need the cheapest and best "reform" it's clear that some form of the Medicare for All bill sponsored by Rep. John Conyers is the route to take. It provides the best coverage for all our citizens--not some---ALL our citizens..."

    Good post. I have always respected Conyers. For decades the same way I respect our new VP. Decades attempting TO DO THE RIGHT THING. Ha

    We now have a budget or will shortly that takes into consideration HUNDREDS OF BILLIONS OF DOLLARS
    spent annually on two wars. w just ignored it in his budget. Or his sycophant's budget.

    The real costs of treating the uninsured are skipped over. the ER, where miracles occur.

    Good post.


    It's just money; here's what we do:

    1) Patients pay 50% of costs of hip and knee replacements,
    2) Family physician pays 80% of cost of his diabetic patient's amputation, and
    3) Decedent's estate pays 75% of cost of last 30 days of hospital stay and in-hospital treatment (in for less than a week, no charge).

    No cutting edge treatments (or rebranded drugs) for middle class or poor people until wealthy (who will pay out-of-pocket) have proved they work. And nothing for quality of life (you weren't promised a rose garden).


    I could probably live with that. Do you think we can get the AMA to sign on to #2? ;)


    Yes, I am sure.

    The idea that "most" people are insured and therefore they are happy with the current system is not true. That line of argument has been manufactured by the insurance industry in the past couple of years. It's catchy, but little more than an attempt to divert attention from the real issue which is that even those who are insured now pay far too much to keep the insurance parasite alive and feeding off the host which is all of us. We can all have better health care if we abandon the current rotten system.

    Despite the willingness of many who are insured to "play it safe" for themselves and let others suffer an uncertain fate their safety is short lived and their selfishness born of fear unjustified. And please note that their position on this changes instantly once unemployed or once they need treatement their insurance company refuses to pay for. The entire society will be better off when all citizens are covered and those who are fearful and hesitant now will pay less for better health care when we finally leave the current system behind where it belongs.

    Our leaders' obligation is to the general good and the public interest and not just to a particular segment of society.


    .

    Oh brother . . .

    Was that an April Fools piece or what? Talk about your inform to conform piece of twaddle out of the skull of some opining "expert"...

    If anyone can make it past the 8 minute mark in the video blog from January 26 at the following link with Ezra Klein discussing health care with Jonathan Cohn then you're a bigger masochist than me.

    Serious subject matter interspersed with self-deprecating giggling and genuine jackass genius of irreverent babble-speak... Allow yourself to at least get to the 2 minute mark and hang on as long as you dare.

    Holy Sacramento ... I'd hate to witness these two when they reach their true middle-life crises.

    ~OGD~


    .

    Hey Oleeb . . .

    It's so damn easy for folks to throw out a line of bullpucky than to refute what 30,603 concerned citizen respondents surveyed as to what the most pressing problems are. But I'm not telling you anything you don't already realize.

    Here, I'll use the picture section, it may be easier to digest for the lazy...

    C. Figures, Tables, and Maps

    And it's not all cut and dried nor black or white on how people feel related to the insurance through employment issue -- From the healthreform.gov/reports:

    Health Insurance through Employment (pages 58-59)

    Many Health Care Community Discussion participants were satisfied with the current employer-based insurance system. In Temple Hills, Maryland, they found, “The majority would like to stay with employer-based coverage only.” Participants from a meeting in Red Lion, Pennsylvania felt, “The employer should still be the primary source of health insurance but the government should be more aggressive against the health insurance companies and regulate costs.” At a breakfast meeting hosted by a health care technology company in Wayne, Pennsylvania, the participants “…also agreed… that eliminating employer-based coverage and converting to another system would be a cumbersome and complicated task. Conversely, some felt that the employer’s role in employee health should actually increase; that employers should become more involved in wellness and prevention programs because unhealthy staff lowers productivity.”

    Yet, numerous Health Care Community Discussions expressed concerns about an employer-based health care system. The “Harold Street Yes We Can Group” from Houston, Texas, felt that an employer-based system is an outdated model. They summarized, “It’s based on a system developed by businesses post-WW II, as a means of competing for employees when wages were frozen. We are the only industrialized country that ties health insurance to employment.” Another group in Green Bay, Wisconsin, agreed with this point, “All felt that coverage by health insurance should not be dependent on employment; it’s exactly when one loses employment that he cannot afford to pay for health insurance.” A bipartisan group from Doylestown, Pennsylvania, forcefully recommended, “Employer-based coverage should be abolished or available only as an elective chosen by both the employees and employer. It should not be the main source of coverage.”

    Several groups noted problems of an employer-based system when people lose their jobs. A diverse Health Care Community Discussion group in Tampa, Florida – including physicians, small business owners, retirees, and parents – were concerned that “if a person loses their job, they are penalized twice: first, in losing their job and then by losing their health insurance.” A house meeting in Ann Arbor, Michigan, shared one family’s personal struggle: “With the loss of her job, [she] also lost all these benefits. While COBRA was available, she was not in a position to afford paying $1,100 -$1,200 a month to continue to carry those benefits, so her family went without health, dental, and vision insurance for just over four months.”

    Other Health Care Community Discussions focused on how an employer-based system limits job mobility. A Madison, Wisconsin, gathering summarized that “one of the other problems with access is that it is so often tied to employment. Since it is now rare to remain with the same job for a lifetime, employers have little incentive to provide health care that covers pre-existing conditions or preventative care.” A conference call Health Care Community Discussion held by a home care and hospice organization in Connecticut recommended, “Portability of health insurance should be a main goal because people change jobs often. The new health care system should allow people to access health care regardless of whether they are working.”

    Pages 58-59,

    healthreform.gov/reports/ ... discussions/Part_III_Concerns.pdf

    And Oleeb -- Thanks for your efforts.

    ~OGD~


    Thanks for pointing out this silly article in TNR. What a joke. Tell me something else that I already know.

    I'm a physician. If health care is a right, then the answer to the cost problem is actually quite simple, but our President is long on hope and short on audacity. Get rid of the bloodsuckers (for profit insurance companie), pool risk (mandatory minimal Medicare for all), and CUT THE DEFENSE BUDGET to reasonable levels. Do we really need to be spending as much as the rest of the world combined on guns and bombs?

    Every time Obama tells me it's health care spending that's destroying our economy, I throw up in my mouth.

    WHAT ABOUT OUR OBSCENE DEFENSE SPENDING???


    Don't the wealthy usually check the teeth of the slaves they buy, to make sure they're healthy before purchase?


    And right on cue Dr. Newman goes all "It doesn't work" on us. Whiner!


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