Saturday, August 8, 2009

Health Care Roundtable


Hello again, Roundtable reader. Welcome to a very special edition of These Gentlemen's signature segment. Once again, we have combined our efforts to form a complex series of opinions on a matter for debate. This week, the Gentlemen tackle the question currently embroiling the country in heated argument. As always, we are open to your contributions as well, but first, take a look at how the Gentlemen answered the following:

You are sitting in the Senate Chamber during the debate on Health Care reform. You are suddenly called upon to give your opinion on the issue. What do you say?

Let us delve immediately into the answers, lest I be accused of being too long.


Bronchitis Graham

My opinion, so far, is to agree with whoever was talking last. So there's that factor. And then there's the rant factor. I'm so mad about it at this point I might not say anything of consequence at all. And then there's my speech style. It would not be sensitive or political. It might be mean. I might call them assholes. I might tell them a personal story or about that commercial I saw in 7th grade about the little boy who had to go to school when he had a fever because it was going to be his only meal that day, come to find out a huge percentage of children struggle with hunger all over the country every day. That doesn't even have anything to do with the health care debate, but I might tell it anyway.

Because I'm not a good debater. I'm not a politician. I'm not a legislator. I am a citizen, living under a government whose job it is to protect me. And I expect it to protect me, keep me safe, keep me healthy if it can. I trust it to not steal from me or allow me to be taken advantage of. I trust it to not allow others to trap me in a circular system that encourages doctors to order unnecessary tests, x-rays, specialists that I have to pay for. I trust it to build a safety net so I don't lose everything if I get in a car wreck (knock on wood) or be in debt for the rest of my life if I fall down a flight of stairs (true story).

I just want something done, and something
done soon. And for everyone to just stop bickering. That's what I'd say.


John Ozkirbas


Sirs and Madams of the Senate, honored am I to be our representative conscience in these dark times, the chamber's council when morality turns to gray, and your north star through the blackest nights. You, fellow senators, turn to me at a pivotal moment in our nation's history for an answer to one of our country's most pressing questions. Should we, as a nation, embrace socialized medicine and universalize Health Care? Can't you tell that I love the sound of my own voice.

The concept, my friends and colleagues, is a noble one. Thousands upon thousands of American workers live their lives daily without the assurance and comfort of the grand blanket we know and love as medical insurance. Their jobs do not offer insurance and they cannot afford to purchase it on their own! Diabetics thirst for their insulin! The injured desperately seek surgery! The Osteopathic hunger for calcium! The ill are dire for well-being! What is a country to do about its standard of living? Universal Health Care does seem to be an answer. But is it the answer? While the needs of the American uninsured remain apparent, evidence regarding decreasing medical standards seem to exist in countries that have implemented socialized medicine programs, as well. Untimely waiting abounds! Cue Jumping ensues! Doctors short on resources! Treatment methods compromised! Private-owned medical insurance becomes a wealthy commodity! Oh, the confusion!

Both perspectives provide a fair amount of concern for the medical system and the people within it. Regardless, Senators, given the financial situation of the country, I feel that now is not the time to implement a social program on as grand a scale as this. We will tell the American people that we are sorry, but that we cannot afford it right now. Be sure to remind them that if they are extra-special good this year and if they go to school and work every day, maybe Santa will bring them socialized medicine for Christmas.


Max Nova

I've gone through this response a few times in my head, and I have already ranted a bit about this topic on my lovely blog, which I'm sure all of you Senators read religiously.

Many of you, the ones on the red team, have thrown around the word "socialization of health care," and I feel it's time for your team to put up or shut up, because you have let the scourge of Medicare and Medicaid go on for far too long. So now's your chance, let's see a resolution right now from your team to end this existing "socialization" right now. *Dramatic Pause* Ah I see you all still want to get reelected in the next two/four/six years. So then your all full of shit. (Can I say shit on CSPAN?) Well shit. Fuck the FCC, then.

Anyway, now for the blue team. You've sucked ass at framing the issue. People hate the health care system. American who can afford it or who get it from their employers gorge themselves on it like a Midwestern family at a Denny's, and they still hate it. Whatever you do to get everyone covered will be an improvement, so get your shit together. Oh shit, I said shit again. Anyway, get everyone covered, it doesn't matter how, a public plan, twisting arms, etc. Get this shit sorted, we've got a lot of important issues still on deck. For one thing, we need some immigration reform, and the red team seem to really dislike people from other countries.


David Pratt


First, I stand slowly. I pause to cast a meaningful look in the direction of both Connecticut's Chris Dodd and Utah's Orrin Hatch. Then, I say the following.

Distinguished Senators, we have come here today to address the health care problem facing our nation. Nearly 20% of our population is without guaranteed health care of any kind. Data suggests that at various points, nearly 33% may have spent time without a plan to cover them. Small business - which makes up two-fifths of the nation's employers - often cannot afford to offer their employees health coverage, and those that can find employees who are unable to cover their share of the premium.

While we argue the cost to the taxpayers, we ignore what it already costs us every year to provide treatment to those without insurance. Let me share with you some numbers from the National Coalition on Health Care. It costs the country $100 billion - that's ONE HUNDRED BILLION DOLLARS - every year to cover the health costs of those without insurance. This is often for disease or conditions which could be treated far more efficiently if caught earlier, or are even altogether preventable. Hospitals spend an additional $34 billion to provide treatment for the uninsured. For Americans themselves, it's another $37 billion for private and public payers for the health care coverage of the uninsured, and on top of that, it's estimated that those without insurance pay $26 billion a year out of pocket.

That amounts to just shy of $200 billion dollars paid out every year because we do not have universal health care. Yet here stand the detractors of this bill, arguing that the cost of implementing it will drive us into irreconcilable debt. My question to you is - with the price tag of keeping Americans uninsured measuring up to a trillion dollars over 5 years, how do we justify not putting a system guaranteeing coverage into place?

I'll tell you how. We stop trying to put a bandage on a wound that needs a tourniquet.

We don't need a universal health care system. Privatized health care has worked in this country since the days of lodges and shriners. The very idea that we have created an industry on and death disgusts me. If you really want to help this country, here's what you're going to do instead of sit here and debate. You're not going to turn this into a political issue which you can scare people with to garner votes in the next election. You're going to genuinely make a move to help Americans. Now listen close.

Put a cap on malpractice lawsuits. Doctors are running scared in fear of these, and each ridiculous award for somebody's frivolous case drives up the cost of health coverage for everybody else. We need to educate the people about what health care entails, and how difficult the work of our doctors and surgeons is. I'm not asking you to keep bad doctors employed, but there's no reason we should penalize good doctors for their mistakes. Those costs tear apart the doctors, the hospitals, and ultimately the American taxpayer.

Find cures for diseases. Not treatments, cures. Fund stem cell research, which will, if properly funded, reduce the costs of health care in this nation by billions of dollars over the next 10 years. Genetic disorders and degenerative diseases can be reversed. There is no reason for us not to pursue a course of action which will so greatly improve the lives of so many in America and around the world. We have a responsibility to the American public to use the resources at our disposal to do more than maintain the status quo. It is time to find a cure for cancer. It is time to find a cure for AIDS.

And stop trying to scare the public, you contemptible vultures. Preying on their fears is going to make the situation so much worse that it can be called nothing less than morally reprehensible. Seek to educate your constituents - notify them of your concerns in a responsible manner. Hold town hall meetings where you can individually address their questions and doubts. This goes far beyond health care, this is for every two-bit politician in this room who wants to pander to the audience rather than do their job. Assuming an elected position is a responsibility and a sacred trust. If this entire issue has done nothing else, it has highlighted exactly how many of you fail to live up to that burden.

Finally, before I take my leave of you today, I just want to ask why no one has put an end to this Sarah Palin creature yet. Senator McCain, you have my utmost respect, but all I can do at this point is pray your substantial legacy will not be forever tarnished by the sin of unleashing that beast on our nation. Don't get me wrong, I'd hit it, but only for purely physical reasons.

Good luck in your debate, gentlemen, and I will see you again in 2020.


Daniel Strauss

I stand up, and I say this.

"Now, I'm a simple man. I don't have any long list of qualifications to be here. In fact, as passionate as I am about this issue, I don't know many of the facts or details. And to be totally honest, I haven't listened to what you gentlemen have been saying today. But I do know this. Every American in this country deserves free health care. They deserve a plan that covers them, no matter what, and for any necessary medicine or surgery. Because if we're not keeping our people healthy, then we're not keeping our people. And the way I see it, government was created by the people, to serve the people. So let's serve the people.

Now. I'll be seeing myself out, seeing as how I shouldn't even be here in the first place."

Then, I'd leave.


Ali Daniels


Holy. Crap. There is so much out there on health care reform that it made my head spin. So here goes:

Clearly, health care reform is a hot button and important topic in America, and for good reason. There are over 46 million Americans uninsured (and that statistic is growing almost daily as insurance companies drop the coverage of increasing numbers of families) who are praying that they or their family members just don't get sick. When the sad and inevitable happens, though, they still need to utilize emergency care services (especially because they typically forego unaffordable preventative care). If they can't pay their medical bills, then the debt falls to the hospital and then to the government, eventually landing taxpayers with the bill. At the same time, hospitals raise their fees to cover unpaid treatments, forcing insurance companies to increase the premiums of the insured because they're footing a higher bill. Prices are too high and continue to soar while too many Americans have inadequate coverage. Something has to change, and it has to change quickly.

And do I have an opinion on what that change should be? Oh do I. But if I'm standing on the Senate floor, it means that I'm there because a state elected me to represent its residents' opinions and best interests. And since I've only ever lived in the great state of Maryland, I'm going to assume that they put me there. So I asked around, and before I give my opinion on health care reform, here's what a sampling of Maryland (and D.C. - because someone has to represent them) constituents has to say about the proposed bill:

(*NOTE: As I only had a week to pull this info together, my sample size is only as big as my gmail address book, meaning these thoughts come entirely from Caucasian, middle to upper-middle class Marylanders. I did, however, do my best to get a healthy mix of conservatives and liberals, ranging from their mid-20s to their early 60s who are both individuals and members of families.)

"We need reform but they are doing so by cutting diagnostics and doctors' salaries while increasing patient load. What we really need is medical liability reform so doctors stop needing to practice defensive medicine."

"I won't be happy until we have a single-payer system."

"What I feel completely comfortable saying now is that this country's medical-healthcare system is horrific; reform is necessary to keep the American people and the economy afloat."

"The Congressional Budget Office has already said the bill is unsustainable. Certainly, American health care, which is the BEST in the world or why do all those Canadians, Brits, and Middle Eastern potentates come to the USA for health care instead of Europe, can be made better and more equitable. The Obama plan for health care reform is the equivalent of using a pick ax to remove a splinter."

"This does not even begin to consider the abortion/euthanasia issue and the immoral treatment of those issues in the current proposals. The aged and sickly and unwanted will lose what little dignity they have left and be reduced to mere 'numbers' who are sacrificed in the name of 'containing costs.'"

"Why not address some of the waste in health care--people on Medicaid get many more benefits than us in some ways. Why not trim trim fluff that insurance pays for? Medical insurance could be redefined and reallocated but don't mess up the whole system."

"It's the right thing to do, to provide health care to the masses. And what time could be better than now for debate? The costs of health care is strangling business profits. I prefer to overhaul government controls of the insurance industry to facilitate delivery of health care to the maximum amount of people at the lowest possible cost through the private sector before expanding the federal system."

"I think people really fear change, and that stops things. We elected Obama because we wanted him to change things - I say let him go."


And I, as average Joanna single American woman, am extremely wary of both HR3200 and the Senate HELP Committee Plan (I'll be surprised if a GOP bill even gets off the ground at this point). They are both unsatisfactory and, as they stand right now, leave too many issues unresolved while creating new ones. Neither does enough to address the greater problem of health care fraud, a problem that is resulting in hundreds of billions of lost dollars every year, making coverage costs skyrocket because insurance companies are paying out to dummy physicians and doctored care claims. (Add to this the curtailing of frivolous lawsuits so that doctors don't have to pay exorbitant malpractice insurance so that they, in turn, can lower their fees so that we're requesting less money from insurance companies.) We need to stop people from taking advantage of our current system before we create new programs for them to swindle.

My primary concern regarding these new programs (both would expand the coverage provided by Medicaid and SCHIP in addition to creating a government-run public insurance option) is their funding - where is the money going to come from? Obama has claimed that his proposal/the proposals put forth by Congress will be paid for primarily by re-appropriation of excess funds that are misused by current programs. There is an incredible amount of data from the Congressional Budget Office and Obama's own Office of Management and Budget, however, showing that in the long run, a lot of these programs probably aren't going to save us money. Both project that adopting these bills would increase the federal budget deficit by hundreds of billions of dollars over the next 10 years. Put plainly, the plan does not pay for itself. Taxpayers (read: US. Not our parents.) will end up picking up the slack. (And this is in addition to the increased tax already proposed on those making more than $350,000/year, which could potentially harm small business owners.) I need to see that the revenue from these bills is going to outweigh the cost before I can support one of them.

I'm not entirely sold on a public option yet either, for two reasons:

1) Both HR3200 and the HELP plan require participation in a health care program, which, I believe, runs the risk of forcing Americans who have lost their jobs, are changing jobs, or who simply want to change coverage, to be coerced into a public government plan that they might not want, which could snowball into tighter government control of who can have what policies. I don't think the government should EVER be the only source of health care.

2) How would a government program deal with the proposed volume of its public option? If the public option will be as good as the Obama administration is claiming it will be, then millions of sick Americans are going to flock to this program, and I have not seen evidence that a government option will have the resources available to contend with that volume of patients. I want to know where they're going to get the health care professionals who are willing to work on a government salary and how they're going to guarantee that those employees are not going to be overworked, understaffed, and underpaid while dealing with far too many patients than they could possibly take on, thereby gravely lowering the quality of patient care.

I'm all about a public option providing competition and driving down the prices of private competitors, but right now I think there is too much potential for these programs to turn into a train wreck.

There are already so many issues with the current insurance system. If we try to generate too much new policy too quickly, we're liable to overlook the current problems while creating new ones. I think we're trying to do too much too fast. It's my recommendation that we take smaller measures to fix the already prevalent issues within the private sector of insurance to curtail spending and include more people in coverage, and then later, if still necessary, add a public option.


Steve Bragale

Obama has been so vague and hands off in this debate that it's hard to tell where this debate is going. He's gone everywhere
from single payer to co-op during his political career. Meanwhile we have town halls where people with health insurance are erupting over a plan that threatens their "liberty". I heard early on that the deficit would increase to over 300 billion dollars over the next ten years because of one version of a health care plan. Sounds epic, but it's only $10 a month per person. Or, $1000 per month for the richest 1% of Americans. This is a money issue. We have the money. Let's correct this.


Jason Schlafstein

Canada.
















So now let the actual discussion begin. All the contrasting cards are on the table. How does the opinion of our Gentlemen stack up to yours? And Gentlemen, what are your thoughts on what your fellows had to say?

Let us hear your thoughts. A matter this pressing requires public debate, and that is what the Roundtable is here to accomplish.

16 comments:

David Pratt said...

So my first comment is -

Jason, in light of John's post, would you like to change your opinion on Canada?

ali d said...

Dan, do you really believe that everyone in this country deserves free health care? Affordable health care, perhaps, but I think free is taking it a little far. Providing health services, even preventative ones, cost money. And doctors go through a lot of school, racking up an impressive amount of debt, to be able to treat you. I think they deserve the salaries they get, and I think that we as Americans should be responsible for contributing what we can to pay for our own health care.

Jason Heat said...

Facetiously - no, of course not. My answer was not in reference to your question. I simply really like Canada.

Slightly more seriously - No. The fact that other places can't get a good idea right doesn't mean we shouldn't endeavor to be the ones to do it.

I'd also like Mounties and better Indie Rock down here too.

B.Graham said...

I would like Canada to be warmer, please. And I'd also like to point out that all their Degrassi stars keep coming down here so maybe we're doing something right.

Also I like how everyone else is a Senator and me and Daniel Strauss are snarky citizens. Actually he's a snarky citizen and I'm just an annoyed one.

ali d said...

Fine then, Jason, I'll put it to you - where do you think we're going to get enough doctors who are willing to work on a government salary to deal with the sheer volume of patients that would arise from a socialized system? I agree with Oz's article - when demand is high and supply is low, people end up waiting to get what they need, and we all deserve at least the decency of rapidly provided medical services.

A story, if you'll allow me: I get really bad migraines if my lady hormones get out of whack. One night, after a particularly bad one made me throw up my Rita's, Oz took me to the ER. Now I know it was a hormone issue, but at the time I was in a lot of pain and I was scared that it was something worse. The doctor in the ER said that I was probably fine, but they did a CT scan on the spot just in case, gave me some extreme pain meds, and sent me home feeling much better.

In Canada I would've had to wait months for that CT scan. What if something had been wrong? I would've gone months without treatment. And once they did figure out something was wrong, how much longer would I have to wait in my new line until it was my turn to receive that treatment?

I don't even think we have enough resources for a government-run public option right now, let alone to socialize the entire health care system.

Jason Heat said...

@ B - i'm pretty sure I'm the snarkiest citizen

Jason Heat said...

i'm likely going to refrain from any further debate for the same reason i didn't answer the question seriously - i don't like putting myself on the spot for things I'm not an expert on, and especially not in a public forum (which is why i write about myself and comics books)

I don't think having a public option will actually draw people who can afford private health care, specifically for those fears. Public education has NEVER stopped the wealthy from persuing private schools for a variety of reasons. And public schools, much like any wide ranging institution, vary in quality from district to district and school to school, based on an incredibly large number of factors. I don't see doctors or hospitals being very different. North Potomac is incredibly wealthy, and yet Shady grove hospital is still called "Shade Grave" for a reason.

The primary people being covered in a well executed public option are likely to be the people who can't afford private care in the first place.

And if you're asking me whether I think certain people should be bereft of service, or all covered at a greater inconvenience, I will always choose that inconvenience rather than have one person denied the services they need.

Capt. said...

Well said Ali, David and Oz.

I think if everyone goes to school and works hard everyday most people will not need socialized health care for Christmas. But on the off chance everyone is good, I think I'll be bad so Santa doesn't bring me socialized health care.

Ozkirbas said...

@Capt. - You scoundrel!

Jstone said...

I agree with Jason, twice.

Canada is a really nice place to live and if you don't mind mild summers and bitter winters you can experience some cool cities (Toronto, Montreal) and breathtaking wilderness (the rest of Canada). Also if you find yourself in Yellow Knife you can drive on some ice, which just sounds cool.

Now for the other thing, America works differently from Europe and Canada. People forget their history and assume that when you set out to do something in two different places you'll get the same result. America is the land of the free in that it is the land of the individual. Individuals like to be comfortable, and comfortable means something different for each of them. If I have a killer job and make a very comfortable living, I will pay a premium to receive a better service or product. Jason's example of private schools is a solid close analogy, but think about everything else people pay a premium for. Sales tax on food doesn't exist unless that stuff is packaged and processed by a company, like say frozen food. You could buy chicken, flour, carrots, etc and pay no taxes or you can just buy the damn Lean Cuisine Chicken Fettuccine and pay 6% extra.

If you can provide the necessary services for people for "free" and then charge extra for bonuses (private clinics, etc) then everyone should be happy. Poor people can shell out a small percentage of their yearly income to provide for things that keep them alive and rich people can shell out a hefty percentage if they so desire to get a quick fix in maybe a more comfortable place.

Choices are good things. At the moment a disturbing percentage of this country's population has no choice, we could fix that if we want.

PS- I'm not really supporting government sponsored health care beyond old people and children (the people who literally can't fend for themselves) but Jason made a good point so I thought I'd throw my two cents in as well.

Dennis said...

Health care is not a right. A lot of people list the "it's our countries job to protect/take care of us so they should keep us healthy" rule.

Well, we all need food to stay healthy too, should the government provide us all with free food?

We all need places to sleep, should the government house us all for free?

No No No.

I am against nationalized health care. From the research I have done:

YES, it lowers the costs overall of providing health care to your nation. This is after time mind you; the initial costs of implementing it would be staggering. Countries that use it also have

YES, it covers everyone who uses the public option equally. Diseases get treated in the ER, rather than symptoms. People who suffer with chronic diseases/pain will be cheaper to take care of.

The bottom line to me is that the majority of Americans are happy with their health insurance. Yes, 45 million Americans are uninsured (half by choice). No one in their right mind believes that socialized healthcare will come without a tax hike. Hell, our government can barely even run Medicare, Medicaid and Social Security. Do we really want to give them more responsibility?

I believe reform needs to happen to lower costs. I like David's idea of capping malpractice lawsuits. People need to stop abusing health insurance when they have it. I feel that health insurance should be more like car insurance. Not something you are going to use every time you get a ding, but something that is there for catastrophe. How do we reign in costs enough to get healthcare to be that way? I have no idea.

Great Roundtable. I really enjoyed the varying opinions/ideas.

Max Nova said...

@Dennis

There are lots and lots of dead people because of a lack of health insurance :

http://www.urban.org/publications/411588.html

But as you are so concerned about rising taxes/deficit rather than y'know, lives, I would suggest you send a letter to your congressman telling them that you and your family will forgo any medicare or medicaid for your natural lives. And feel free to cc me a copy. I know you will do your part for our deficit.

Dennis said...

@Max

I guarantee there would be more people dead if the federal reserve collapses, foreign investors pull out of the U.S. and the dollar becomes worthless because of irresponsible overspending and borrowing.

I wish money didn't exist and we were all treated as equals in society too. I wish we could all just be nice to each other and doctors could just heal everyone for free.

Unfortunately, we don't live in a picture book. Medicine costs money (rightfully so). Doctors charge money (rightfully so). It is sad that poor people live shorter lives for various social/economic reasons including lack of health coverage, but there will always be people who are on the lower end of the social stratus.

Although it makes sense from a monetary point of view, we both agree people shouldn't be sent away from hospitals. I couldn't do that as a doctor, and I wouldn't expect someone else to deny care. That's why I'd like to see us lower costs and provide some assistance to lower class families. NOT pay for everything for everyone.

I'll go ahead and write that letter to my congressman when you write one as well. Yours should say that you and your family are willing to pay 30-40% income tax, as well as 19% VAR tax on all sales, on top of your other forms of taxation (savings tax, land tax, homeowner tax, gas tax, etc. etc.) for the rest of your lives in order to alleviate the suffering of the uninsured.

That's how much you would be paying based on your salary if you lived in France. They have the number one rated nationalized healthcare plan on the globe. And hey, if you get really sick, you have to take into account the costs to fly to the U.S. to get the top level treatment that our system manifests.

Max Nova said...

@Dennis - If we had the quality of life of Sweden (or to a lesser extent France) I would pay the corresponding tax rate without a second thought.

Dennis said...

I suppose that is the difference here. I would prefer to control my own money, even it means a potentially lower quality of life.

Honestly, the more I research nationalized healthcare the more open I am to it. It's really not as bad as it's right-wing detractors are claiming it is. I still haven't fully crossed over yet though.

Jstone said...

@max

Sarah and I are 50/50 on moving to Sweden, you should come with.