Sunday, June 21, 2009

Public Option Now!

An email I sent to a bunch of friends and family today:

Greetings fellow Americans,

I have never tried to start a pass-along email before, but this issue seems so important that I hope you will excuse me for doing it now. Whether you see yourself as right, left, or centrist, I am hoping you will send this email to as many friends and family members you know who will consider reading up on what I see as the most important aspect of the healthcare reform that the Obama administration is currently trying to push through: what is known as the "public option."

I am hoping this email might encourage liberals and lefties like myself to learn even more, and back even more, the "public option" over an unrealistic "single-payer" system. Let's admit it: single-payer in the U.S. is just not going to happen in our lifetimes.

I am also hoping that some conservatives out there might be able to look beyond their usual dismissals of a public option as "socialized medicine" and take some time to at least understand better what they are fighting against--and, more importantly, to understand the difference between a "single-payer" or strictly public system and the private-public mix currently under consideration in Congress.

I am hoping our country will work toward a public-private mix, one that has a viable and complete "public option" for any American who wants it, and one where those desiring more or better healthcare would be free to purchase private insurance. Beyond seeing the establishment of a strictly public system as unrealistic in our country, I also see it as potentially unnecessary since people should be free to purchase private insurance for more or better healthcare than what the state can provide, even if the state is providing great care (as, I believe, it is morally obliged to do). The goal is to get every citizen of the state basic health care, and any private option should be just that: an option. It should be secondary and not get in the way of a viable, prevention-focused, womb-to-tomb public option.

As reported on June 20, 2009, a NYT/CBS poll shows that there is currently "wide support for government-run health" in our country: "Americans overwhelmingly support substantial changes to the health care system and are strongly behind one of the most contentious proposals Congress is considering, a government-run insurance plan to compete with private insurers [known as 'the public option.'] The poll found that most Americans would be willing to pay higher taxes so everyone could have health insurance and they said the government could do a better job of holding down health-care costs than the private sector."

If you are worried about higher taxes, you should know that the average insured American family currently shells out $1000 per year for the cost of the uninsured. It is called a "hidden tax"--and this is just the cost of the uninsured. Just think what the "hidden tax" is for insurance companies' profits--companies like AIG who have recently received $173 Billion in a government bailout. After AIG received their first $80 Billion, "the company sent executives on a $440,000 retreat to a posh California resort." Later AIG would balk at the claims of AIG-insured passengers of the jet that was ditched in the Hudson. There's free-market efficiency for you!

Would you rather have an AIG bureaucrat between you and your doctor, or a government employee? Why are government employees so maligned? Soldiers, by the way, are government employees. Actually, given how much we tax payers have given AIG the only difference is that the AIG bureaucrat gets a much larger salary and a big fat bonus if he or she buys up some toxic asset and helping AIG become "too big to fail." Also, this report by the Commonwealth Fund argues that it is clear that the government does a better job at running its part of Medicare than the private sector does with its part, called "Medicare Advantage" (see this post by Maggie Mahar which lists the myriad ways Medicare Advantage amounts to an insurance company scam). As Paul Waldman argues, Medicare Advantage shows that "the government pays insurance companies more to provide a service it is providing to other enrollees for less."

The U.S. spends more for less in general, according to a World Health Organization report: "The U.S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance.... The United Kingdom, which spends six percent of gross domestic product (GDP) on health services, ranks 18th." In 2007, according to a report by the the National Coalition on Health Care, the U.S. spent $2.4 trillion or $7900 per person on healthcare, which constituted 17% of GDP. So we spent 17% of our GDP for a 37th ranking, while the U.K. spent 6% of its GDP to be ranked 18th. That is more than bad health care; that's bad business, fiscal irresponsibility. It's also immoral because that 17% of GDP, that $2.4 trillion, leaves 50 million Americans uninsured.

I think most would agree that our current insurance-company-based healthcare system does not work. It is in fact, broken. Very sick. A "sicko" in both senses: ill and also pervertedly immoral. The Institute of Medicine of the National Academies estimates that 18,000 Americans will die this year due to being uninsured. I know a 23 year old who is right now putting off a much-needed second heart surgery because she is worried she can't afford it, and she can't get insurance because of her pre-existing condition. What should she do? Yes, she could die if her heart valve fails due to the scar tissue from the first operation, one she received when she was six months old. If she doesn't get the operation soon, and she doesn't die, her life is at risk of being really hurt or ruined by a variety of health issues her heart problems could cause. 18K die each year, but how many millions of Americans' lives have been egregiously hurt or ruined by being uninsured?

Not only is this immoral; people like this person with a bad heart valve end up costing more over the span of their unnecessarily unhealthy lives. The same WHO report ranked the US 72nd in overall health. According to a report by the Johns Hopkins Bloomberg School of Public Health, "promoting the health of young children, before five years of age, could save society up to $65 billion in future health care costs." What could we save by focusing on preventative health care in general?

You might ask yourself why the so-called "competition"of our current system has failed so miserably, and why basic healthcare is not a basic right like education--why the myths circulated about the Canadian system are so often accepted as fact. I ask why would anyone defend a system ranked 37th overall in the world by the WHO? Right above Slovenia, but way below number-one-ranked France. Even those liberals at BusinessWeek agree that "the French system--a complex mix of private and public financing--offers valuable lessons for would-be health-care reformers in the U.S."

Let's put away our usual prejudices about the French, the Canadian healthcare system, and knee-jerk reactions to government health care as "socialist" and take a serious look at a "public option" that would lay the foundation for the U.S. system to move toward where it has to go: a more viable and ethical "mix of private and public financing." It has to go there because we cannot afford our current "sicko" system: it is too expense in dollars, lives, and needless suffering. Health care should be a basic right here in the U.S., just like it is in every other advanced nation. It's obvious to almost anyone who has grown up in an advanced nation. Please pass this email on so we can get more people educated about what it means to support a "public option." We need a viable public-private system where health care is treated like a basic right.

Thanks for your time.

The Baggage Handler

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