Critics of "Obamacare" Actually Describe the Status Quo

Recently, Digby wrote a post about the pathological tendency of right-wing activists to insist that their rights are being trampled while they themselves push to shut down town hall meetings intended to inform the public about health care. Death threats, violence and other efforts to close down debate are coming from the same people who insist that a fascist tide sweeping America is strangling their right to air their views. About this phenomenon, Digby writes:

I know. This kind of full-on psychotic projection is disorienting and weird. I've never been very good a dealing with this particular wingnut tactic and I don't think anyone is.

That post got me to thinking more prosaically about the main right-wing talking points against health care reform. What is striking about those talking points is that every horror that the right-wing alleges is a feature of Obamacare is actually a mainstay of American health care as it currently stands. Below are five broad claims against Obamacare that fit this pattern.

1) Claim: that Obamacare will entail runaway costs, exploding our deficits. Reality: We currently spend far more than any other OECD country for health care relative to GDP. And every significant proposed cost-control initiative -- like a public option, or allowing the government to actually negotiate lower prices with the pharmaceutical industry -- is being attacked full-on by opponents of reform. There is simply no serious debate about whether our insanely convoluted, privately-based insurance system is far more expensive than any comprehensive single-payer system would be.

2) Claim: Obamacare represents a frontal attack on Americans' freedom, including their freedom to choose the health care that is best for them. Reality: The current market for health insurance in the United States is, for most Americans under the age of 65, a state-by-state market. And, far from being characterized by competition and choice, most states' health insurance markets are highly concentrated, with near-monopolies in numerous states. A public option would, in fact, clearly give many Americans more choice and more freedom than they have now, because Americans' fear of losing health insurance constrains their job mobility.

3) Claim: Obamacare will mean runaway bureaucracy. Reality: Private insurers are far more bureaucratic and far less efficient than is Medicare, whose overhead costs are a fraction of the private insurers. Why? Because private insurers incur massive expense trying to figure out whom to insure and to whom they should deny coverage. Universal systems, like Medicare, don't have this problem. Some defenders of the status quo insist that private insurers incur high bureaucratic costs because they are trying to prevent fraud. But this is bogus. Fraud is a concern for Medicare and Medicaid as much as it is private insurers. Just ask Rick Scott. He's a ringleader of the anti-reform movement. He's also the founder of Columbia/HCA, a health care company that had to pay $1.7 billion in fines to the federal government, the largest medical fraud case in U.S. history.

4) Claim: Obamacare means rationing of health care. Reality: let's leave aside, for the moment, the hysterical claims being made about socialism trampling on our rights to get the care we want. The fact is that we now have rationing of health care. Every time an insurance company denies a claim, it's rationing health care. And denials of claims, as sentient American knows, are endemic in our system, as is the related practice of rescission, whereby insurance companies try to strip policy-holders of their coverage once the policy-holder becomes sick and actually needs coverage.

5) Claim: Obamacare will set up death panels that will play God and decide who gets to live and who is condemned to die. This meme has become a staple of anti-reform propaganda and Sarah Palin weighed in this weekend to say that her son Trig might have been doomed to death by one such panel. Reality: We already have bureaucrats determining who gets to live and who gets to die -- insurance companies do this everyday. Chris Hayes, writing in the Nation, tells one such story:

I am 36 years old and have Blue Shield HMO health insurance coverage through my employer. In January 2009, I was diagnosed with metastatic (stage 4) breast cancer.... My doctors prescribed a medication that targets and removes the cancer throughout the body like a "smart bomb"; however Blue Shield of California denied coverage of my doctors' recommended treatment. Blue Shield also denied a radiation procedure that would target and remove the two lesions in my brain. In both cases, Blue Shield denied the original requests and subsequent appeals I filed on the grounds that the treatments are not a medical necessity. I have learned that insurance companies will use "medical necessity" as an excuse to not cover treatment when it appears that the patient is "too sick" (read: not worth it).

There are, of course, many, many stories just like this one.

In sum, everything the anti-reformers hate about Obamacare is a feature of the current health care system in America, a textbook case of projection.

Jonathan Weiler's second book, Authoritarianism and Polarization in Contemporary American Politics, co-authored with Marc Hetherington, is due out from Cambridge University Press in August 2009. He blogs daily about sports and politics at www.jonathanweiler.com
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Comments

[RBRagain]

Points to consider:

1. Our public spending is higher than most OECD countries for their entire social systems. To spend the same amount as a % of GDP we must eliminate all spending done by anyone who currently has private insurance.

2. To eliminate the monoplies, offering the public option should include reducing the restrictions on insurers by allowing consumers to buy plans from different states. To rebutt the competition question, if the public option can sell across state lines so should an insurer regulated by their home state.

3. Medicare has had the advantage of paying the large dollar end of life claims on the elderly. Once processing smaller claims as well the admin costs will increase to that of the insurers - or more. It costs about as much to process a $50,000 claim or a $500 claim.

4. Rationing under a social system happens. I had a 28 day MRI wait in the NHS, but the next day with employer sponsored private medical insurance. The providers supplement low Medicare reimbursement levels by charging more to private insurers. That support decreases substantially under public funding, thus rationing.

5. Here's what happens: A value per year of life is established and you have to be expected to outlive the cost per year to get the treatment. Example: 40 yearsold, $500k treatment to extend life 20 years. If value per year is $50k X 20 years = $1,000,000 'value', treatment. 85, $500k treatment for 2 years of life extension, no

[MODI]

great article!

We have to kill em with the facts and that's what this does! I have also been saying the same thing, but not nearly as well or as succinctly articulated

[michelle2388]

The reason people are getting so mad is because the FINE print on the health care plan.
Everyone has to remember our politicians are LAWYERS!!!! They are only going to tell you enough to create chaos - and make you think its all good.

THEY will NEVER tell you the bad points of anything. Lawyers, politicians, used car salesman they are all the same....wi­ll tell you enough to make a sale. I would love to see every US person have insurance - but not under this plan. Nothing will ever be perfect - democratics are using cases where insurance companies denied coverage - I'm sure this happens with medicare too.

I encourage everyone to read the health care proposal line by line for them self and not listen to rumors/nei­ghbors/pol­iticians .....

[mamalisa38]

For profit health insurance is immoral. The only way to maximize profit is to raise premiums and deductibles and deny claims. The only answer to our health care crisis is single payer.

[conguy777]

We don't want the government telling us how to raise our kids and telling us how we should live our lives.

[Deschris]

Jonathan how can we get you on 60 minutes with this point by point factual information,it will blow the cover off all the lies from the insurance companies and the republican­s.All the perceived ills are in the current system.Gre­at factual article.An­d to think some right wing doctors are fighting reform,it's all about profit and money.Disg­usting.

[pontesisto]

If you would like to help pressure Congress to pass single payer health care please join our voting bloc at:
http://www.votingbloc.org/Health_Bloc.php

[michael320]

Well said. I'll be passing this around.

[Cassie129]

I will try again.

Great post, succinct and to the point about the winger mentality, although fact-based.

:))

Nina.

[Cassie129]

Great article! I will make sure to share with my friends! You put together a concise, point by point argument.

Nina

[Elizabeth Markovits]

Could it be so simple? I love it.

[LesleyAnne]

I would like to see more educators going on tv, particularly the Sunday talk shows, and bringing this information to light. Not everyone reads books, but masses watch television. Sunday talk is a popular medium for political discourse, or, in this case, misinformation from opponents of any type of reform.

[quietfortoolong2]

Misinformation is what's killing reform, not the reform itself. Death by lies.

[ZhangZish]

I'm not going to any town halls to shout at politicians, but I'm still going to ask: what reason do any of us have to believe that the Health Care Bill will actually solve any of these problems.
1. The Congressional Budget Office has unequivocally stated that 'Obamacare' will increase our federal deficits over the next ten years. Reduce per-capita costs? Maybe. Increase cost to the Federal Government? Without a doubt.
2. It's absurd to say that a public option will solve the problem that people face when they can't buy insurance across state lines. Why not just allow people to buy insurance from any provider in any state?
3. While public health care may shrink the private beuracracy, it will certainly increase the size of the federal beuracracy.
4&5. As long as we limit ourselves to simply focusing on cost and access, we will continue to wrestle with the questions of who to treat and how. With the public plan, the Fedaral Government will replace private insurers on the death panels and rationing boards. If they can do a better job of it, then by all means, let's have them do it. But arguing that they won't perform these functions is blind.
It is your responsibility as a supporter of the health plan to convince me otherwise, but you just waste my time by attacking your opponents instead of supporting your own position. Why?

[quietfortoolong2]

1) Link? The CBO has also stated that a universal, single payer system will end up SAVING money over the long term verses the status quo. If money is the issue, why aren't we going that way, then? The truth is, the elected officials that have been bought off don't care about the budget, or you, or me. If they did, they would have raised heck when the last administration LOWERED taxes during a WAR. First time that ever happened in the history of civilization. A war fought on credit.

2) I agree with this statement, but I also feel that a robust public option will introduce real competition and force insurance companies to either provide better services, or go out of business. I won't miss them.

3) Public health care will increase the size of the bureaucracy, but so did creation of the Department of Homeland Security. If growing the gov't by even 100,000 employees could guarantee coverage for the vast majority of the 50 million uninsured, then do it.

4,5) My parents had care through the VA and medicare, and at times when they were knocking on death's door, with a battering ram, they were never denied care or medications. I don't think there will be rationing, but I would rather someone tell me there is not enough of some drug, than to be told that even though something is available, I can't have it because it would reduce some bean counter's bottom line.

[Eric Neuman]

Genuis, Single Payer systems never save money, they simple shift the numbers around. For instance, the Santa Monica system that was proposed supposedley would save the state 6 million a year after implementation, but that's if you don't consider the fact that they want to raise the capital gains tax to 15.5 percent as well as raise the payroll tax for people making AS LITTLE AS 7000 DOLLARS A YEAR to as high as 16 percent. In other words, those people would lose almost one sixth of their income to their health care costs. The state may save money, the taxpayer will see more coming out of their individual paycheck and won't save a dime.

Also, singlepayer healthcare would bust on the same grounds of why medicare and Social security are both going to: their eventually exists a point where there will be a retired population in America numbering as many as the working population based on our population growth (somewhere around 2040) when that happens the amount of people taking money from single payer healthcare will EXCEED THE AMOUNT PAYING INTO IT. In other words, the entire system WILL GO BANKRUPT AND NO ONE WILL HAVE INSURANCE.

So unless you can force doctors to work for free (pretty sure the constitution doesn't allow that) your system NEVER WORKS IN THE LONG TERM. EVER.

[quietfortoolong2]

I posted a comment on another blog stating the exact same thing, although not as in-depth! THANK YOU for bringing this information to light!!! Democrats NEED to stop playing defense of the policies that are in the reform bill, and start making the other side defend the immoral, unjust practices of the status quo. We need to turn around the debate and show that the very same things that people fear reform will bring are the same things they are fighting to keep in the current system. It's a cruel irony, but one that is not lost on the opposition. It's an old debating tactic that still has the ability to manipulate the ignorant masses: present your weaknesses as those of your opponent, and they will have to work double duty to debunk the lies and then present those same arguments as truth. Well, the sooner we get this ship turned around, the better off the national discussion will be. Debate health care with facts, not lies!!

[ThePeacemakers]

Quietfortoolong2,

It's classw arfare that scares the dems in Congress. And that's what you have to do to take down the status quo. They see it as dangerous. Besides, the upper classes are their peers.
Not you and I.
They feel like they're between a rock and a hard place.

Oh, well, nothing left for us to do but squeeze them between it.

[DannyDanson]

Thank you for this common sense straight forward article, this is exactly what is missing in this debate a rationale intelligent and mature consideration of the current health care regime, as compared to the prospects of reforming specific aspects deemed effective in reaching long term goals and aspirations of the Nation.