Desperate Times, Half Measures

In the closing days of the war for Iowa, the battle over health care rages on.

"It would be extremely unfair," Obama's health care advisers recently blasted, "to enact a mandate before we make health care affordable." Take that, Hillary, you dirty insurance-peddler!

"He's called his plan 'universal.' Then he called it 'virtually universal,'" Clinton herself fired back, "But it is not either." Bang! Pow! Feel that, Obama, you misleading politician, you!

If it sounds utterly insane to imagine this half-hearted policy wonkfest as some kind of a heated debate... It should. The only remotely interesting thing about this most nuanced wedge issue of all time is that both candidates seem more aware of their opponent's plan than of their own. So, please allow me to explain the Clinton and Obama plans to their respective candidates: They're both awful, and they're both a hell of a lot better than the big nothing we have now.

You see, Clinton, Obama and Edwards have centered their health care plans on getting some form of coverage for the estimated 40-47 million Americans without insurance. To uninsured Americans and a nation facing nothing short of a major health care crisis, this sounds like a godsend. And why shouldn't it? The situation, quite simply, is desperate.

A Harvard study released in February of 2005 concluded that just under half of all people filing for bankruptcy met the definition of "major medical bankruptcy." In order to meet this definition, a debtor had to have unpaid medical bills meeting a certain sum, lost at least two weeks of work due to injury or illness, or mortgaged a home to pay medical bills. When researchers expanded the definition to include events like childbirth and death of a spouse, over half of all those filing met the criteria.

The stories researchers uncovered were heartrending, to say the least. Sixty-one percent of these working and middle-class families skipped necessary medical care, 30 percent had lost utilities, and 22 percent actually cut back on food just to make payments on their debt. The last must have been a tough cost to trim, since Americans already spend more on health care than they do on food.

Here's where things get really frightening (and the candidates' plans all fall apart): Seventy-six percent of these people had medical insurance. Many of those lost it when they became ill and therefore unable to work. For the rest, it just wasn't enough to cover the staggering costs of an out-of-control system of medicine. Researchers concluded that a national health insurance system could eliminate half of all bankruptcies, sparing about 2.2 million hard-working, bill-paying citizens from financial ruin every year.

The powers of darkness that comprise the US congress acted quickly, joining forces to pass a solution just six weeks after the report was released. Their answer: A bill that made it harder for Americans to file bankruptcy. With 19 Senate Democrats voting "yea," it was truly what is known as a bipartisan effort -- a cause so misguided it took the collected effort of both parties to rationalize it. For the record, neither Clinton nor Obama voted in favor of that bill. Clinton wasn't around to cast a vote (Bill was recovering from a heart surgery that could have plunged many Americans into bankruptcy,) and Obama voted "nay". However, their fellow hopeful Joe Biden did creep over to the dark side on this one, as did John McCain, the only Republican thus far to offer a serious health care plan.

Now, three years after the Harvard study and subsequent legislative atrocity, Democrats are spending millions bickering over who can most effectively implement a solution that won't address 76% of the problem.

And that's not all they won't address. None of the plans stop the horrific gouging of sick Americans by drug companies. None of them address preventative care in a serious way. None deal in a substantive way with the real-life problems of faster access, sure to only worsen as more become insured (except, strangely enough, for McCain's). And do any of them seriously consider how insurance companies will react to mandatory insurance? Just imagine all the "affordable" plans that will spring up, all covering nothing at a very reasonable price. And, yet the bar for American health care debate has been set so low that these plans can actually be seen as major progress.

I hate to beat a dead horse here (but it arrived ill and that was all its PPO would pay for): The only possible solution to this catalog of problems is a national, single-payer health care system.

It's been stated many times that virtually every essential public service is handled by the government, except health care. Rightly so, since it seems a rather absurd omission--the very purpose of government is, after all, to provide a basic level of safety. If you're mugged, beaten and set on fire, the government will hose you down and even punish the guy who did it. You're just on your own when it comes to those potentially-fatal burns. The 10.5 million Americans with cancer are on their own, too--unless the Saudis decide to suddenly invade the Ozarks. If that happens, the government will totally have their back. Strange priorities indeed.

Sadly, the health insurance industry, drug companies and lobby firms have bilked Americans out of a lot of money for a long time, and they've anticipated the threat of socialized medicine for just as long. So the arguments against a national health care system have been repeated so many times that they've become ingrained in our collective psyche. Government bureaucracy ruins everything, even though Medicare is far more efficient than private insurance. Free-market health care systems lead to better treatment, even though every indicator says just the opposite. You won't be able to pick your doctor, even though that isn't how it's worked in the countries the program is modeled after. The lies have become so accepted that politicians fear to challenge them.

As long as we allow them to, our leaders will offer us small solutions to big problems. Clinton got burned in 1993, and now makes no secret of the fact that she won't do anything until we've built "a national consensus." The US health care system has class IV hemorrhaging and our leaders are tossing us band-aids. It's probably too late for Iowans, but if the people of New Hampshire, Michigan, Nevada, South Carolina and Florida demand to see a real doctor, eventually, they might get one.

Comments

[kart125]

The problem is that all of the candidates seem to believe that the healthcare problem can be solved in sound bites. If that were the case it would have been solved long ago. No one has ever demonstrated anything remotely close to a comprehensive understanding of why it's not working. And until that is understood how is it even conceivable that a solution can be devised? It's a bit like your automechaninc randomly swapping out parts without having first diagnosed the problem. But that seems to be what counts for many people: "By God I'm going to do something to fix the problem even though I don't know what it is and even if it only replaces one dysfunctional system with another dysfunctional system" And now for my sound bite: people claim they want European style healthcare yet seem to think that is somehow going to happen without a European style tax regimen. People say they want it but nobody is finding the bags of money it's going to require.

[deminmo]

When I had health insurance 2 years ago, I was
covered under a PPO that paid 90 percent. My
deductable for one person was $200. I paid a
$15 co-pay to visit the doctor, which went up
to $25 but still pretty good deal.
Since then I pay for everything out of pocket,
which right now is about $1200 down from an
original debt of $1600. I pay $60 to visit a
doctor (which now I don't) and medication that
used to cost $10 now costs $30.

Anyone on a fixed income, age 65+ who takes a
lot of medication and has Medicare and private
retiree health insurance, like my folks, spend
almost $200 now on NEEDED meds a month.

We need REDUCED prices on the cost of getting
the private insurance, REDUCED cost of meds,
REDUCED cost of co-pays and acess to ANY
hospital, physician or specialist. The decision
to stay in or leave a hospital should be
the DOCTORS decision, not the cost analyisis
expert of the insurance company.

This is my formula for allowing people like me
who do work but don't get insurance, to be
able to have it. Less write-offs on bad medical
debt for hospitals. Less people using hospital
emergency rooms as a primary medical resource.

But, the reality is the next President will
fight an up-hill battle to get anything to
change. And the ones who campaign now are
already, for the most part, indebted to big
pharmacudical companies, and the insurance
companies.

[YankeeCanuck]

Mr Womack, you've certainly nailed health care as one of the great challenges facing the next President.
Here's what Biden has proposed, in outline. Immediate catastrophic care for those with higher than usual health care costs (to prevent medical personal bankruptcies). Immediate enrolment for children and young people under 21.Adults may buy-in to a plan like the federal employees plan on an income-adjusted scale. Those over 55 may buy-in to Medicare on a sliding scale. Small business to have help providing insurance with a share subsidized by government. Insurance reform with backup funding to help with health care costs of the formerly uninsurable-- the insurers can no longer refuse insurance.Better care for our veterans with injuries, including mental health.
Overall, an emphasis on prevention education to encourage Americans toward healthier lifestyles.

Since Biden announced his plan some months ago, others have adopted bits of it. He has given specifics on what it is, and how it would be funded.

[Akonitum]

Larry Womack,

I think maybe you haven't read the Democratic candidates' health care plans. Else why would you have written this?

"None of the plans stop the horrific gouging of sick Americans by drug companies. None of them address preventative care in a serious way. None deal in a substantive way with the real-life problems of faster access, sure to only worsen as more become insured (except, strangely enough, for McCain's)."

You're wrong on these points.