Wednesday, October 27, 2010


One of the many disconnects in the ongoing health care debate (which is by no means over) lies between the Republican mantra that Democrats are destroying the Best Health Care System in the World and the prevailing view of the medical community. This view holds that the BHCSITW, although capable of providing world-class care, has nonetheless devolved into a ramshackle Frankenstein cum Rube Goldberg machine in a state of near collapse. According to this view, the BHCSITW
  • relies on an insurance business that opens the system to the healthy and closes it to the sick, resulting in an ever increasing number of uninsured without access to care;
  • shifts the cost burden onto patients and providers;
  • rations care by denying coverage, limiting coverage, delaying payment, and establishing caps;
  • is inefficient and burdened with administrative costs;
  • shortsightedly discourages preventative care, creating long-term health problems and costs in interests of of short-term profit;
  • discourages competition;
  • prevents consumer knowledge and choice;
  • discourages the tracking, recording, and dissemination of information about outcomes;
  • impedes providers and patients from acting on such information in the few instances that it exists.
Now, I get that the Sarah Palins and Jim Demints and Cosgray families buy into the BHCSIW drivel. I even understand how a reactionary doctor like Tom Coburn could sincerely believe that it all comes down to physician compensation (even if he is being narrow, shortsighted, and inconsiderate of his patients). But intelligent politicians such as Eric Cantor, Mitch McConnell, and Olympia Snowe must know better.

One can only conclude that they are cynical, craven, and/or laboring under the illusion that the BHCSIW would be the BHCSIW if only they could Get Government Out of Health Care (GTGOOHC). But what does that mean? Literally, GTGOOHC means:
  • repealing the Affordable Care Act
  • privatizing Medicare/Medicaid
  • privatizing the Veterans Administration
  • ending the employer/employee tax exemption on health care expenses
  • defunding the Center for Disease Control, the National Institute of Health, the Food and Drug Administration, and the Bureau of Alcohol, Tobacco, and Firearms
  • curtailing or ending clean air and water regulations
One could argue that GTGOOHC goes so far as eliminating the 55-mph speed limit, removing warning labels from cigarette packaging, and no longer requiring cars to have seat belts. It sounds extreme, but I'm describing a classic libertarian position, and at least one classic libertarian is favored to become the next U. S. Senator from Kentucky.

Given that list, GTGOOHC is about as likely to happen in this country as a single payer system: There are too many special interests invested in the status quo to permit such a radical change, nor would the electorate stand for it. Instead we'll lumber along with the Only Health Care That Can Be Squeezed Out Of Our Broken Political System After Seventy-five Years Of Straining & Groaning (OHCTCBOOOBPSASYS&G).

In any case, the when the rightist politicians talk loftily of GTGOOHC, it's just that: Cheap talk. They don't have the guts to explain what it really means, nor do they have the evidence to make a serious case for it. Unless you count sloganeering and quotes from Ayn Rand as evidence...


paula said...

Great backgrounder. Hope you continue feeling alright, Joe, cuz ain't nobody gonna help ya if yer not.

paula said...

It's hardly worth repeating at this point, but I put up a post last year right after the HCR vote with data showing that many of those representing districts with large numbers of uninsured, voted against affordable health care for their constituents. The entire list, including percentages of uninsured for each district, was available on TWP. Does anybody read this stuff, unless they're in an MBA program? Why not?
Thank you K for posting this, and for taking the time to train in health care admin. At least there'll be one more enlightened health care leader out there, in spite of the GOP's push to extinguish the flame of reason.

Steven said...

I'm shocked...did you really mean it when you wrote that Eric Cantor, Mitch McConnell, and Olympia Snowe were intelligent politicians? Okay, maybe Olympia but Mitch? Or Eric?

K. said...

They're smart, smile-as-you-kill types. Which hasn't kept Cantor from a true believer, McConnell from being a Wall St toady, or Snowe from being a coward.

K. said...

Thanks, Paula. What I'm learning about how other wealthy countries handle health care should embarrass the media for not telling an easily-learned story. I'll write more about it later, but -- for example -- single-payer has not only not threatened any country that has it with bankruptcy, it has alleviated economic difficulties brought about by the recession.