Writing--where else?--on the op-ed page of The Wall Street Journal, Whole Foods C.E.O. John Mackey presents the non-ignoramus's argument against what he calls "ObamaCare." This, in contrast to the all-ignoramus's arguments lately heard at town halls/brawls/mauls across the length and br. of the land. Let's see what he recommends.
After the usual throat-clearing about the projected deficit, Medicare and Social Security and Baby Boomers and etc., he lays on us his overall theme: "...we should be trying to achieve reforms by moving in the opposite direction--toward less government control and more individual empowerment."
When a C.E.O. trumpets "individual empowerment," watch your wallet, warm up your lie detector, and keep an eye out for someone--usually a non-union "team member"--tasked with clobbering you over the head with a copy of Atlas Shrugged. Here are Mackey's eight proposals:
• Remove the legal obstacles that slow the creation of high-deductible health insurance plans and health savings accounts (HSAs). The combination of high-deductible health insurance and HSAs is one solution that could solve many of our health-care problems. For example, Whole Foods Market pays 100% of the premiums for all our team members who work 30 hours or more per week (about 89% of all team members) for our high-deductible health-insurance plan. We also provide up to $1,800 per year in additional health-care dollars through deposits into employees' Personal Wellness Accounts to spend as they choose on their own health and wellness.
This sounds nice, but does that mean that Whole Foods is offering employment to those Americans--let's use the conservative figure of 40 million--who have no insurance? Or the Christ-knows-how-many-millions who pay for their own insurance? Bragging about how Whole Foods' "team members" have health insurance paid for by the company seems not germane to a discussion centered on the health insurance of people who have none, whose employers provide none, or who pay for their own, retail.
•Equalize the tax laws so that that employer-provided health insurance and individually owned health insurance have the same tax benefits. Now employer health insurance benefits are fully tax deductible, but individual health insurance is not. This is unfair.
Sold. Let's stop here! No? Oh all right...
• Repeal all state laws which prevent insurance companies from competing across state lines. We should all have the legal right to purchase health insurance from any insurance company in any state and we should be able use that insurance wherever we live. Health insurance should be portable.
Well. As I recall David Caruso saying in the pilot of NYPD Blue, "now we're getting into a bad area." I foresee this as leading to insurance companies at each other's throats (in the "conservative"ly approved manner), resulting in predatory pricing, increasing concentration, and the eventual creation of regional or national monopolies. Or, if that's too violent and upsetting for you, arranging nice, amicable cartels. Eventually we would have a "single-payer system," with the single payer being a private corporation beholden only to its (institutional, secretive) shareholders (if there are any), its bonus-grubbing executives, and its almost-certain-to-be-corrupt board of directors. With Grandpa's (i.e., my, soon enough) hip replacement at stake! Because I'm not as hip as I used to be.
• Repeal government mandates regarding what insurance companies must cover. These mandates have increased the cost of health insurance by billions of dollars. What is insured and what is not insured should be determined by individual customer preferences and not through special-interest lobbying.
This is hallucinatory. Does Mackey imagine that "what is insured and what is not insured" would ever be determined, in private health insurance, by "individual customer preferences"? Is he unfamiliar with the term "pre-existing conditions"?
• Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year. These costs are passed back to us through much higher prices for health care.
Yeah, this old wheeze. Actually Claire McCaskill (D., MO) put paid to this myth at a recent town hall. She pointed out that several states, including Texas, have indeed enacted tort reform, that medical lawsuits have indeed diminished in number and in awards in those states, and that, as a result, exactly no one's health insurance premiums have been reduced.
• Make costs transparent so that consumers understand what health-care treatments cost. How many people know the total cost of their last doctor's visit and how that total breaks down? What other goods or services do we buy without knowing how much they will cost us?
This is beyond hilarious. As if knowing that you are--or someone is--being charged $11 for the box of Kleenex ™ used in your hospital stay, qualifies as "transparency." Mack seems to think that the charges and costs are valid; it's just that we're not being smart shoppers.
What he can solve in his next op-ed, then, is this brain teaser: Last year my daughter had to go to (the hilariously named) "urgent care" for a bad stomach ache. She saw a doc there we like and who was simpatico and attentive, but he couldn't figure it out. He sent us to the E.R. across the street, where we spent six hours. The patient had an x-ray, an ultra-sound, an MRI, and other procedures. By the end of the day they had no idea what the problem was. They gave her a scrip for Vicodin and sent her home. (She was better the next day, thanks.)
We got a bill for $12,000. Because of stupidity on my part, I had allowed her insurance to lapse. When the hospital learned of this, they immediately cut the bill literally in half. About which I was, like, "Thanks," and all, but here's the puzzler: What happened to the missing $6 K? Is it how the hospital bilks the insurer? Who, in turn, raises premiums?
That's the problem. Not assuring that we get itemized bills.
• Enact Medicare reform. We need to face up to the actuarial fact that Medicare is heading towards bankruptcy and enact reforms that create greater patient empowerment, choice and responsibility.
Baloney. Terms like "greater patient empowerment" and "responsibility" are always, when brandished in a WSJ op-ed, code words for "stick it to the customers and defend the corporations." Implicit in this discussion (and in his rhetorical question above, "What other goods and services do we buy...") is the insidious assumption that "buying health care" is just one more consumer act, no different from "buying snow tires." You read the reviews, you compare prices, you talk to the guy at Pep Boys, and you buys your chemo.
People like John Mackey should acknowledge that spending money on health care is unlike spending money on anything else in the world. You are entirely at the mercy of your medical professionals. No amount of Consumer Reports printouts or Epinions can be applied to the topic of your own--or, worse, your child's--body. And you are not competent to judge the correctness of what you're told. Oh, and: everything is at stake. Exercising "choice" and accepting "responsibility" are right-wing flash grenades meant to impair or halt the discussion. They're meaningless in this context.
• Finally, revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance and aren't covered by Medicare, Medicaid or the State Children's Health Insurance Program.
Excellent: forty million people dependant on the kindness of strangers. Spoken like a naïve Christian, an aristocratic reactionary, or a blinkered libertarian, none of which are meant to be terms of admiration.
He goes on:
Many promoters of health-care reform believe that people have an intrinsic ethical right to health care--to equal access to doctors, medicines and hospitals. While all of us empathize with those who are sick, how can we say that all people have more of an intrinsic right to health care than they have to food or shelter?
Health care is a service that we all need, but just like food and shelter it is best provided through voluntary and mutually beneficial market exchanges. A careful reading of both the Declaration of Independence and the Constitution will not reveal any intrinsic right to health care, food or shelter. That's because there isn't any. This "right" has never existed in America.
Yes it does. It says in the Preamble to the Constitution, "Look, don't worry. As long as you have your health, you have everything." No, wait, I'm thinking of a different document. The Preamble says, "...in order to...promote the general welfare..." If John Mackey doesn't think that health, food, and shelter promote the general welfare, he should go live in Soviet Union, where general welfare promotes you.
In other words, just as patriotism is the last refuge of the scoundrel, so "a careful reading of the Declaration of Independence and the Constitution" is the last, and sometimes first, refuge of the wing-nut. These people must be told, over and over (although they already know it; it's not as though they're arguing in good faith) that we can have the kind of society we choose to have.
If the Constitution permits slavery, and we decide our society shouldn't condone it, we change the document and improve the society. If the Constitution does not allow women to vote, and we want a society in which women do vote, we change the document and create that improved society. If the majority of us agree that the basic hallmark of a civilized society is that every member of it deserves to be as healthy as possible, we can create that society.
Mackey then includes some debate-society nerd-points ("Even in countries like Canada and the U.K., there is no intrinsic right to health care. Rather, citizens in these countries are told by government bureaucrats what health-care treatments they are eligible to receive and when they can receive them.") which beg every significant question, beginning with why forty-nine countries--including Wallis and Futuna, which I always thought were two claymation characters-- have longer life expectancies than the U.S. (Source: The fucking CIA, okay? http://tinyurl.com/yrq7l8.) He cites some supposed-to-be-horrifying statistic ("Although Canada has a population smaller than California, 830,000 Canadians are currently waiting to be admitted to a hospital or to get treatment, according to a report last month in Investor's Business Daily."). That's 2.5% of the Canadian population. What are they waiting for? Elective procedures? Are there no Americans "waiting to be admitted to a hospital or to get treatment" for similar reasons?
He clouds the issue with this bit of squid ink:
At Whole Foods we allow our team members to vote on what benefits they most want the company to fund. Our Canadian and British employees express their benefit preferences very clearly--they want supplemental health-care dollars that they can control and spend themselves without permission from their governments. Why would they want such additional health-care benefit dollars if they already have an "intrinsic right to health care"? The answer is clear--no such right truly exists in either Canada or the U.K.--or in any other country.
Does this make sense? He seems to be asking, "Why would Brit and Canadian employees want 'supplemental health-care dollars' they can spend anyway they like?" To which the next question is: Who wouldn't? The answer is clear.
Then comes some summing-up lecture about obesity, diet, and a disingenuous little suggestion about "a diet consisting of foods that are plant-based, nutrient dense and low-fat."
But enough already. If you secretly felt that you "should" really shop at Whole Foods, because they're "whole" and they're "foods," you now have your reason to go elsewhere--both for food, and for arguments about health care.