Sep 15, 2009
Thank you, Joe Wilson
I don’t think I need to tell any of you what Joe Wilson did that launched him to national infamy (infancy?), or really describe the fall-out from his outburst. You’re all smart people who read a lot and are up on current events. (At least I imagine you are. I hope like crazy that you’re not like the nutjobs that comment on newspaper websites.)
Anyway, why am I, an avowed Liberal, thanking a back-bencher Congresscritter from South Carolina?
Wilson (unwittingly, I’m sure) opened the door to an honest assessment of just how unhinged from FACTS the ultra-right is in all of their dealings.
President Obama stated that the proposed reforms to Sick Care would not cover illegal immigrants, and that statement is a FACT.
Joe Wilson called the President (of the United States, in one of the most hallowed halls of representative government) a liar because the President has stated that he doesn’t support the onerous, nearly useless, and VERY expensive citizenship verification requirements that Republicans have tried to write into the bill. (Language that is very similar to the disenfranchising voter ID BS they’ve tried repeatedly to ram down our throats, despite NO EVIDENCE WHATSOEVER of actual voter fraud happening as a result of a lack of legislation.)
So, who’s the liar?
Not the President. The current House bill states clearly that illegal immigrants are not entitled to the coverages provided by the reforms. Because Joe Wilson doesn’t like that the President disfavors Joe’s pet anti-immigrant and anti-poor-person provision doesn’t make the President a liar or his statement a lie.
What ultimately comes out of this is clear evidence that ultra-cons really don’t care about TRUTH or FACTS or actually TALKING about sickcare in real terms. Instead, they’d rather demonize Democrats for actually trying to DO SOMETHING about our completely failed and unfair system. (A system from which a very few people get VERY rich, which — in case you haven’t guessed by now — is the only thing that ultra-cons give a shit about.)
So, thanks Joe, for exposing the truth of your party’s complete and utter rejection of reality and honest debate.
Was it appropriate? No. But I think it is safe to say that both sides of the aisle can be called guilty of similar things, at varying times of course.
I also think it’s fairly blanketing to say that an entire party has a “complete and utter rejection of reality and honest debate”. That’s just not fair to individuals who may identify one way or another. It’s all encompassing concepts like that that are a little disheartening in general.
To say that D believes R to be entirely without reason or open mind. When in fact D may be so completely entrenched in that opinion that R has no way to convince them otherwise.
Of course either side can convince themselves that the other is “to unreasonable for reason”. To be sure, the table turns both ways.
___
Unrelated: In my opinion there are so many flaws and so much hypocrisy on both sides of the aisle that it just gives me a massive headache.
There are virtue’s on either side of this debate.
The Democrats essentially want to establish some degree of a social safety net so that people can receive decent care at a reasonable cost. An admirable, logical, and necessary agenda.
Now to what degree those services are paid for by the Federal Gov’t depends on your particular flavor of altruism.
The Republicans are concerned with the fiscal ramifications of establishing a large Federal role in the administration of health care. Another admirable and understandable agenda.
To what degree the Fed Gov’t should establish bureaucracy and buget toward such a goal depends on your particular flavor of laissez faire.
The truth lies somewhere in the middle. Any working person can tell you that pneumonia will leave you in debt and cancer will bankrupt you. And it ain’t getting cheaper.
Peripheral to political philosophy there is the matter of greasing the wheels:
The Republicans are beholden to insurance lobbies. And the Democrats are beholden to trial attorney lobbies.
Let me tell you a story I know through personal dealings.
A Hispanic girl in the fourth grade needs glasses. Her teacher noticed. No big deal. She can go to the doctor and they will give her a prescription and the glasses themselves, all for free. All she has to do is show her social security number.
The problem is that she doesn’t have a social security number. The problem has now left the teachers hands. But not to worry, because the girl simply borrows a family members social security card to obtain the glasses.
Now, of course, any particularly socially liberal person would argue that you simply can’t deny a child such a necessary item, regardless of citizenship. OK, we can accept that as a valid argument. Not the only point of view, but a valid argument none-the-less. After all, the child did not choose to A) immigrate illegally or B) have poor eye site.
But then there’s the teacher, who may also need glasses. And simply can’t get them for free. But making well under $50,000/yr, such an addition to the monthly budget is a little troubling.
So what are we to do? Hand out glasses to illegal aliens with borrowed Socials. While a citizen struggles to afford them. Mind you a citizen who feels they have done everything they can do to play by the rules and pursue a career educating the future. Struggling to pay for a doctoral level education. Of course, unwed mothers get tuition breaks for their doctorates, but it’s full price if you’ve spent your life playing by the rules.
The answer certainly isn’t to expand the income requirements for the free glasses program. Why, you ask? because we are all ultimately splitting the glasses bill in our taxes. Our deficit gets more top heavy. And because we have simply created another set up people (albeit higher up the economic food chain) who have legitimate claims that they too can’t get a break for playing by the rules.
So, the FACTS (as you call them) sometimes simply are not so clear. The FACTS are sometimes easily circumvented.
Here’s another good one for you.
A Children and Families organization in far, far Western Texas has a summer day camp program for children.
The program recruits children to come to the camp, and they tell the parents not to worry “it’s free to them”.
So the organization enrolls the children and lists each one as having a particular disorder. ADD, ADHD, what have you. The Fed’s then reimburse (via grants) the organization for educational activities for children with disorders.
In fact the children have no disorders at all. But the organization needs the money, so they file claims like clockwork.
Finally someone blows the whistle and reports it to the organizational board. This is fraud after all, it’s federal fraud but the ultimate tab lies with the taxpayer. The chairman of the board calls her a whistleblower for reporting the organization. A blatant and disdainful dismissal for having the guts to point out systemic criminal activity.
The “whistleblower” was my mother. I fear that gargantuan medical bureaucracy can invite widespread fraud at the expense of taxpayers.
I think that my posts here have been real and honest. Me actually talking, without demonizing anyone, or making accusatory remarks of any kind.
I remember in a casual conversation when I told someone that I voted for Bush. She started screaming and pointing and telling me to leave. I was never so disheartened and disallusioned. It was a really sad moment for me to realize that people can be so irrationally closed.
I’m sorry you felt like you had to pre-emptively defend yourself. You have certainly displayed reality and honesty in your examples and your stating of your positions. You’re exactly the kind of conservative who should be engaging in debate with liberals where it matters, instead of demagogues like Wilson, Palin, and the rest who reject reasoned and honest debate for scare tactics.
I disagree with your assertion that the FACTS are “not so clear.” The FACTS as you presented them are very clear. The teacher is in an unfortunate situation, and the child’s parents are breaking the law in any number of ways, and they deserve to be punished. As another one of those people who played by the rules, stories like this cause me a fair amount of disgust as well.
The sad fact is that there will always be people who game the system, whether the system is public or private.
I’ll reverse the question: How much fraud and waste is acceptable in a system set up to cover everyone? Would these cases of fraud have happened in a system that was set up to cover everyone? (With the exception of the illegal immigrant, who’s crime happened way before the fraud.) How much of this kind of stuff actually goes on? I don’t have exact numbers (no one does, that’s the trouble with fraud), but I’ll bet it’s WAY less than some would have you believe.
Lastly, I’m honestly dismayed by your claims of “gargantuan medical bureaucracy”. Have you tried dealing with a private insurance company? My wife broke her ankle last year, and dealing with all the different insurance companies and “care providers” (in quotes, because I think she got lucky and was assigned to a PT that actually gave a shit, instead of the rest who were just collecting a paycheck) was a NIGHTMARE. I’ve never had an experience like that with a government agency. In fact, ALL of my experiences with government run medical care (6 years of seeing Navy doctors and dentists while I served in the Marines) have been outstanding in terms of “bureaucratic hassles.”
Pete,
I appreciate the response. I will take a harder look at it after work hours.
You make a good point about reversing the question. Fraudulent claims from individuals would most likely be nill under a system designed to cover most everyone. Unfortunately, institutional fraud (where the motive is more about income) would probably be either unchanged or grow.
No doubt that there are most likely similar hassles to dealing with large beauracracies as there are with large insurance corporations. The only advantage I can see with corporations is that in theory people can vote with their feet. So we could assume that company with bad customer service wouldn’t do very well. But that’s probably limited in reality because people don’t change providers on a whim of bad service.
Large Federal Bodies scare people. The pervasive understanding is one of financial waste, and inefficiencies. But that’s all debatable.
When we start talking about covering everyone with a single bill to the government, we get back to the “public option” debate. Which you could probably write an entire book/blog/thesis around in itself. So in short. I personally dislike the idea because it seems to create a welfare mentality. The buck gets passed to the taxpayers, and there are reasonable arguments to be made that the quality of service goes down (see Europe).
Obama gave a pretty good speech with some reasonably moderate ideas. Presumably it wouldn’t be to much of a burden on the budget (although I wonder how much of that is D.C. fantasy math). All sides had items to enjoy and dislike about his proposal. But unless you are to the extreme one way or another, it was a reasonable plan.
Personally, I just think that if we are really serious about getting costs down. If the costs are at the heart of the matter. Then we should be curbing the mesothelioma attorneys, and wild damage awards. They cost the system, which shows up in HC costs, that then gets passed from the care providers to the consumers. It’s not a silver bullet, but it’s a damn good place to start.
Austin,
I’m sorry, but the “quality of service” argument using European healthcare programs as an example just doesn’t hold water if one makes an honest evaluation of the outcomes of our current system and the successful ones in Europe and/or Japan.
The fact is this: Americans spend 16% of GDP on healthcare (or as I call it “sickcare” — more on that later). 6 of the largest European countries spend 11% of GDP or less.
Spending is one thing, let’s consider outcomes: I’ll point to two areas, and then I have a few questions.
First: Infant mortality rates — The United States (the wealthiest country in the world, mind you) ranks either 33rd or 46th, depending on whether you go by the UN’s statistics or the CIA’s.
Second: (And this one is kind of scary) Life Expectancy — The United States ranks 50th in life expectancy according to the current edition of the CIA World Factbook.
Now the questions:
Why do large Federal Bodies scare people? The US Army is a large Federal body. So are the Navy and Air Force. No one is scared of them. We have Reagan to thank for his bullshit statements about people fearing government. If our founders had wanted citizens to fear their government, why the hell did they form a new one?
Do malpractice suits really cost as much as we’re lead to believe? How much does the cost of malpractice insurance really affect the end cost for the consumer? (Mesothelioma settlements are largely against the companies that exposed their workers to asbestos, etc., not the doctors treating them.) Also, what is a “wild damage award”? What if a sleep-deprived doctor cut off your right leg when you were in there to have your left one amputated due to advanced diabetes? Punitive damages exist in our legal system as an attempt to motivate more careful behavior on the part of companies and service providers. The fact that these things are still happening demonstrates that there’s still a use for those kinds of judgements.
The United States has a higher incidence of cancer and diabetes than most of the rest of the developed world (yes, I know that’s a squishy claim — it’s my blog, dammit!). Why? Is it because our system is better and therefore we report it better and the numbers look inflated, or is it because we actually have higher rates of these generally preventable diseases which were practically statistical anomalies 50 years ago?
Now the claim:
Our system isn’t expensive because of lawsuits or malpractice insurance or onerous regulations or anything of the sort. Our system is expensive (and largely ineffectual in two hugely significant areas of measurement, according to the CIA) because people don’t seek care until they’re already sick, sometimes disastrously so. If insurance companies and the government focused more on encouraging healthy eating and living habits, rates of diseases like diabetes, cancer, and heart disease would decrease, along with the exorbitant costs that come with treating them.
Additionally, those three diseases (since they’re apparently my example benchmarks) disproportionately afflict lower-income people who are less likely to have insurance in the first place. Leaving aside the education and lifestyle stuff for a second, what happens when a person without insurance has a heart attack? They go to the emergency room, and since they can’t pay, and they have no insurance to charge, the costs of treating them is passed on to those of us with health insurance or the government. I assure you that once they’re in the emergency room, no expense is spared in saving that person’s life. That’s one reason that people point to how awesome our system is — we truly do have passionate, brilliant, and talented doctors and nurses here. Unfortunately we don’t recognize their passion and brilliance until they do the impossible and bring a horrifically sick person back to health. It’s too bad they don’t have the time or incentive to focus that passion and brilliance on keeping that person from getting to that point. (But that’s boring and not nearly as profitable for insurers, hospitals, drug manufacturers, fast-food joints, processed food companies, etc.)
My point is this: If you’re looking for waste in the system, start at the beginning and not the end.
Also, the solution for institutional fraud is to remove the profit incentive.
Diabetes, life expectancy, etc. No doubt, and I am sure that you agree, that it is largely personal choices that cause the US to rank so low. En masse, (as Bill Maher says) Americans are stupid. Don’t construe this as a hatred towards Americans, but the average person is just stupid. From McDonalds, to Coors Lite, and Starbucks. We feed ourselves full of shit, regularly, and (you being a former Marine can understand) we underestimate exercise.
But is it really up to the government to tell us what we should eat? Is it their job to “encourage better eating and living habits”? Seems a little totalitarian to me. Sort of like making a national issue out of taxing cokes. It’s just not the job of the government. I don’t need them telling me what to eat.
Is the military an inflated Federal body? Yes! Do we need bases is Germany and Japan? NO! Maybe I might go against the perceived neo-con (which I would never claim to be anyway) belief on this, but that’s why I voted for Ron Paul.
You are right about Mesothelioma, that was my mistake. But the punitive damages awarded are largely levied against doctors and hospitals. It is a burden. The implied liability is still further a burden, but you are also correct about starting from preventative points of view.
Anyway.
I am tired of talking about this. You certainly seem very educated about the topic, and I have to admit that I basically snoozed through Public Policy of Health Care.
So I am happy to of contributed largely to your content here. If you want to go get a beer sometime I have changed the email on my last two posts to my main one. I never check the Info@FWRE address. Would be interesting to talk.
I think there’s a HUGE gulf between the government “telling us what to eat” and funding education for healthful dietary and lifestyle choices. There is universal agreement among dietitians and physicians on what constitutes a healthy diet and baselines for exercise that everyone needs to be healthy. Surely basing a public education program around that wouldn’t be considered “telling us what to eat.”
Now, if the government started closing McDonald’s stores in Houston and Louisiana to fight obesity, that’s a totally different thing. Then I agree that they’ve crossed the line.
I also generally agree with Bill Maher, but he has the benefit of being educated, wealthy, and white when he makes those comments. I’m confident that he’s not including himself or other educated, wealthy, white Americans in his calculations of Americans being stupid.
So, if we put political correctness aside and talk honestly about the problems, obesity and its related illnesses disproportionately affect uneducated, non-wealthy, non-white people. There’s no profit incentive for private corporations to educate that group on healthy eating and lifestyle, yet they are the biggest drain on our sickcare system because they’re more likely to be the ones going to the emergency room for “routine” things that the rest of us would just schedule an appointment with our doctors for.
Also, from a societal perspective, think for a minute how much money is spent researching new ways to encourage people to eat more healthfully and exercise. Probably not very much, because we pretty much know all there is about those topics.
Now think about how much private research money is spent trying to find a pill that will prevent people from gaining weight or that will reverse the effects of a lifetime of crappy eating. How much is spent trying to perfect surgeries that basically FORCE people to eat less and therefore lose weight?
Why is it so unbalanced? It’s unbalanced because there’s a hell of a lot more money to be made feeding us conveniently packaged crap which causes us to gain weight like never before in our evolutionary history, then even more money to be made in selling us pills and “diet systems” to help us lose the weight.
It takes an entity with no profit motive to step in and put an end to all this BS, and unfortunately the government is the only one big enough to have any effect.
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