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U.S. Healthcare Reform Devoured by Sharks

December 18, 2009

They smelled blood, in the form of a plump healthcare package nibbling at the fisherman’s line. Meanwhile, the fisherman had a bundle of crises to manage. Preoccupied by Afghanistan, Wall Street, the Great Recession, sinking ratings and a premature Nobel Peace Prize, Obama briefly looked away.

It was enough. The sharks moved in, circled around and began to feast. First the rapacious jaws ripped out the single payer model. Nothing fatal… healthcare reform could live without it. But the next strike was more devastating: the sharks seized the public option and the early Medicare buy-in plan, chewing them both to a ghastly pulp.

Nearly reduced to a skeleton, the doomed creature now looked grotesque enough to repel even those who had admired it. The gasping hulk drifted slowly downward, trailing a cloud of blood and dashed hopes. The sharks, bellies full, rejoiced as much as sharks can rejoice over anything.

Joe Lieberman and his friends in the insurance industry must be rejoicing, too. I still don’t pretend to understand how the wizened Connecticut senator and man-without-a-party suddenly gained so much power over the healthcare proceedings. It might have had something to do with his standing among the insurance giants who fund the campaigns of so many of our elected representatives. But I could be wrong.

I’ve also wondered why the president has submitted to the dismembering of Obamacare with scarcely a whimper of resistance or regret. Somebody even more powerful must be holding a knife to his throat. But again, I could be wrong.

Our venerable republic is the only industrialized nation on earth without a universal healthcare plan. Our citizens are still free to go bankrupt when they have the temerity to contract a serious disease. And naturally, they’re free to die.

Why are we Americans unique among the more enlightened nations in our freedom from universal health coverage? It might be that our fabled spirit of rugged individualism predisposes us to shun safety nets. But I also suspect that our corporatist climate is especially congenial to sharks and their allies. Even when those allies are moderates who should know better, like Lieberman and Obama. Of course, I could be wrong.

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14 Comments leave one →
  1. December 18, 2009 1:44 am

    Pretty sure the only thing Lieberman supports is keeping Connecticut defense contracts in place. Wrote about this on my Hot Sheet this week. Check it out.

    capitolpresspass.com

  2. Priscilla permalink
    December 18, 2009 11:14 am

    Ah, Rick, no moderate spirit here.

  3. December 18, 2009 11:57 am

    Priscilla: I think a moderate healthcare solution would have been to offer both private and public options, and let the people choose. (The two systems would also keep each other affordable and honest, in the best tradition of free enterprise.)

    The leftist solution would have been a totally revamped, government-controlled system of socialized medicine. I wasn’t for that. What we’re left with is a right-wing corporatist’s dream: private insurers REQUIRING us to buy their product… at prohibitive prices, of course. The self-employed and unemployed will be suffering more than they already do under the current system.

    That’s my (extreme) moderate opinion.

  4. Priscilla permalink
    December 18, 2009 11:28 pm

    Hmmm, I’ve got to respectfully disagree with your view of moderate healthcare reform. Any public option, by design, is a precursor to a government controlled plan. That is not a moderate solution. That is a statist solution.

    And, while I agree that the bill currently being rammed through the Senate is a nightmare of both statism and corporatism (the combo formerly known as fascism, I might add), I wonder why you would call it a right-winger’s dream? I know of no right wing individuals or groups that aren’t fighting tooth and nail against it. Oddly enough, they are now being joined by left wing groups, who hate it equally, but for different reasons. It is a toxic mess, pure and simple, will certainly make things worse rather than better.

    I think that a moderate view of healthcare reform takes an incremental approach, rather than a radical one, and stays away from increased government control, as well as taking away the anti-trust exemptions that the corporate health insurers have enjoyed and abused for so long. Add in some meaningful tort reform, make insurance portable regardless of employer, and improve Medicaid benefits for those who cannot afford their own insurance, and you’ve got the start of a universal system that is not a socialized one.

    • December 20, 2009 10:22 am

      Priscilla: I agree with you on tort reform, portability and anti-trust legislation. But there will always be one fundamental problem with an all-private healthcare system: it’s simply not in the interest of corporations to cover older and high-risk individuals at affordable prices. I can understand their reasoning, of course: they’re not charities. But what happens to older, self-employed individuals (like me) who earn too much for Medicaid, aren’t old enough for Medicare and can’t really afford to shell out $8-10,000 a year for private insurance?

      This is where the public option would have been critical: to keep vulnerable individuals and families from falling through the cracks in the system. A good healthcare system shouldn’t have cracks, and Americans shouldn’t have to go broke getting sick OR insuring themselves.

      Well, the healthcare debate still hasn’t entirely played out. I’m hoping for a few last-minute compromises. Either that or they start from scratch next session.

  5. December 19, 2009 8:33 pm

    You got it. This is a bad bill and poor motives are driving it. We went from Rick’s sharks to everyman’s piranhas tearing this bad bill and making into a worse bill.

    Question: Why don’t the Dems do some good instead of just talking about doing good?
    Example: They have a 60 vote Senate. Why not pass a bill that would just address the expiring Cobra problem.? Is this rocket science? Would the Reps oppose this and other smaller bills that would have bi-partisan and common sense approval? Of course not. Buying improving (HCI) health care improvement now, these “improvements” could then be rolled into a overall bill, hopefully with minimized grandstanding by the publicity loving party leaders. After a while getting along a little could become a habit; practice makes perfect.
    And, I think many liberals are looking for a partial scapegoat, and big corp, big union and
    obstructing people like Dean and Joe, hide the admin and congress in the fog.

    • December 20, 2009 10:27 am

      dduck: Hmm, I like the idea of individual “small” healthcare bills as an alternative to the mess we have right now. I think Congress should have been able to come up with a viable overall plan, but since that’s not happening, the multiple-bill approach might be the way to go. And yes, there have been plenty of scapegoats along the way… though I think most of the goats deserved their status.

  6. Priscilla permalink
    December 20, 2009 10:51 am

    Rick,

    Improving and reforming Medicaid would solve the issue of uninsurable Americans (i.e. provide a “safety net” which, I submit, is all that the government should be concerned with) without destroying our current excellent hospital and doctor system and taking free choice away from every citizen. Right now, if you eliminate those who are uninsured by choice, in the country illegally, or eligible for Medicaid but not enrolled, the approximate estimate of actual “uninsurable Americans is about 12 million – out of 350 million ! We are destroying a system that works for an overwhelming majority of people, and creating an inferior system that will still leave many without coverage – not to mention reducing the number of available doctors and hospitals.

    I also disagree that public option would solve this problem. You simply cannot expect private corporations, which, by definition, must show a profit to compete with government subsidized entities, all of which are massively in debt. It’s impossible. Obama has cited UPS and Fedex as examples, but the Constitution protects the US Post Office, which currently cannot handle its job, despite being $7.2 billion in debt. Add the public option to the individual and employers mandate, and you would have socialized medicine in less than a decade, for sure. And the Dems certainly know that.

    A moderate view: FIX the cracks in the system, don’t destroy it. Unfortunately, moderate Democrats seem to be in short supply these days,

  7. Valdo permalink
    December 21, 2009 5:58 pm

    I came from a Communist country and whenever I was sick or had an accident or needed a periodic medical check – there was not a single problem at all! They asked only for my identity treat me, make a file and pay nothing!
    Romania had excellent doctors, they had the best salaries and the health care was good. Indeed the doctors had not the luxurious life of US doctors, but the point was that everybody in Romania to have health care.
    I do not imply that the US should have a communist system of health, but at least to have kind of health care you see in Europe or Canada.
    I may not understand very well the insurance system in the US, but what I understand is that if I have no job I will have no money to pay for the health insurance. As if being unemployed is not bad enough. When I am working I try not to miss the working days going to the doctor, for I’d be considered not reliable worker.
    Also I know that the US health system is “for profit” in an area where profit should not be a purpose.
    I know a lot of people who want a public health care, but it seems that the rich will be taxed more. In Europe and Canada the rich are taxed more and thus they show that they care fore their countries.
    So what if US rich are taxed more? Let them to show their patriotism by helping every American!

    • Priscilla permalink
      December 22, 2009 12:10 am

      Valdo, I have heard the same from other Europeans – that it is wonderful to be able to get a check up or emergency care without concern for payment. And I agree that it is a nice benefit, especially if it is other people’s taxes that pay the bill. However I have also heard that expensive screenings and diagnostic tests have a long wait, and in the case of diseases like cancer, those waits can be deadly. My own daughter was treated for cancer as a 5 year old, and I met a Canadian family at our cancer center who paid out of their own pocket to get treatment for their child because that treatment was not approved or available though their government system, because it was not considered cost effective. That experience has influenced my view of this issue greatly. I think there are many sides to the healthcare debate.

      But I guess it is reassuring to hear that you were happy with government controlled healthcare, since that is the direction in which we are going.

  8. Valdo permalink
    December 22, 2009 8:10 pm

    Priscilla, it seems that anything that is controlled by the government is making you uneasy. For all I know, the US Army is controlled by the government, the spending is astronomical, but it seems that is OK with you?
    You say that: :”…it is wonderful to be able to get a check up or emergency care without concern for payment. And I agree that it is a nice benefit, especially if it is other people’s taxes that pay the bill.”
    I want to pay taxes for people of US of A to have a public health care. Oh… but I guess that being unemployed I cannot fulfill that wish.
    Now, who are “other people’s taxes”? The guys who don’t want to pay taxes from their profits? Isn’t it normal to pay taxes for your country to prosper?
    Everyone pays taxes for Army to have a secure country, why not pay to have also a healthy country?

  9. December 22, 2009 9:48 pm

    OK, I think we could use a moderating influence here. And who better than the New Moderate himself? As a moderate, I would hope for a middle way between today’s chaotic “too bad if you can’t pay” system and total government control over who we can see and which procedures we’re permitted. That’s why I thought a compound system of public and private insurance would be ideal.

    Priscilla, I know that public competition would put insurers under pressure. But they could position themselves as “premium” brands catering to corporations and wealthier individuals. I have to agree with Valdo that health insurance really shouldn’t be a for-profit enterprise. Not because I have anything against free enterprise, but because the people who need health insurance the most (e.g., the elderly and the sick) either can’t obtain it or find it prohibitively expensive. This is just plain wrong, any way you look at it, from any point on the political spectrum.

    We have a few options: establish low-cost public health insurance that doesn’t come tangled in miles of red tape. Red tape isn’t exclusively a public phenomenon, of course. (Today’s private HMOs are way too meddlesome and restrictive, in my opinion.) Another option would be to force private insurers to offer affordable insurance to high-risk individuals. Maybe the goverment could agree to take up some of the cost.

    Eventually we’ll also need pretty stringent tort reform, so doctors don’t feel pressured to prescribe costly tests and procedures just to cover their backsides. (I’m sure M.D.s would appreciate not having to shell out $100,000 a year for malpractice insurance.)

  10. Priscilla permalink
    December 24, 2009 10:32 am

    I apologize for not making myself clear. Valdo, I am well aware that the government is in charge of the army. That is a power that the government has under the US Constitution, and I might add that membership in that army – for now – is voluntary.

    The US government has no constitutional right to force you to buy health insurance…. for yourself or for me. Well, unless this current bill becomes law – then you will risk going to jail if you don’t fork over your hard earned cash to a big insurance company. That is fascism, right here in the good ol USA..

    Rick, I understand where you are coming from. You want health insurance to be affordable, accessible to all, and to not have health insurance companies be allowed to reject people, either because of their poverty or their poor health. I think that is every decent person’s wish. It is certainly mine.

    But why not repeal the Macarran-Ferguson Act (which gave health insurance companies an exemption from the anti-trust laws) and eliminate the price-fixing, bid rigging, and coverage restrictions that this exemption enables? Why not set up a government agency, like the SEC, that could regulate the insurance companies to make sure that they are not trying to screw the people (the new HC bill could have included all of this , by the way, but big insurance companies lobbied against it with gigantic wads of cash for our politicians)? Lastly, why not take the public health insurance options that we DO have (Medicare and Medicaid), eliminate the red-tape, waste and fraud within them, and rework them to become true safety nets for the uninsured? And, while we agree on tort reform, that is simply not going to happen as long as the trial lawyers maintain their overwhelming influence on Capitol Hill.

    I do believe that they system is broken and needs reform. I just don’t believe that a government takeover is the way to go. I believe that what we are seeing is not reform, it is a power grab by greedy politicians and fat cat insurance and pharmaceutical lobbies. But what do I know, lol?

  11. Taliesin Knol permalink
    January 8, 2010 9:59 pm

    The system isn’t broken, and it works fine. Just not at what it’s supposed to do. it works fine at making wealthy people wealthier, and poor people poorer. Just like most things do. The problem is that money has too much inflence on the government, and that means the people who have money, have the influence, and in the “good ol US” the people with money, are assholes (White:)

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