Saturday, March 25, 2017

Political theater and distractions from HR 676, The Expanded and Improved Medicare For All Act

Once again, I see that the anti-Trump memes are becoming more and more severe, more radical and insulting. Now I'm not a Trump supporter by any measure, and I can understand the catharsis of making these memes. But I fail to see how they translate into public policy decisions that support progressive objectives.

What I do see is that in the days and weeks leading up to a crucial vote on the TrumpCare/RyanCare/WeDon'tCare bill? A lot of political theater about health care, including counting votes, lots of meetings, press conferences and overtures for the votes. Many of us are experiencing considerable angst regarding health care. So it is with a sigh relief that I see the GOP delaying the vote because they can't make the Democrats on the left or the selfish Freedom Caucus on the right, happy.

I could feel that angst myself. But instead of creating a new meme about Trump, I called the offices of both of my Senators and my Congressman, and let them know of my strenuous opposition to the GOP health care plan, and then I urged them to support and vote for HR 676, the Medicare for All bill currently circulating in Congress (they're all Republican, but at least I said something).

In case you're not aware of HR 676, this is the one that if passed into law, prohibits private insurers from offering health insurance that would compete with expanded Medicare, covers everything from preventive care, to hearing aids, eyeglasses and prescription drugs, and it's all financed with simple taxes that are easily calculated. If you want a tummy tuck or nose job, you're out of luck, but private insurance may be there for you if need be.

Under HR 676 preventive and catastrophic care would be covered. Nobody goes bankrupt. Everyone pays in, no one gets out. The risk is spread across the entire population. If passed as it is, it will be nearly impossible for business to externalize the cost of health care.

The entire point of this exercise is the struggle over who pays for it. Conservatives in Congress seem to be of the belief that business must be able to externalize the cost of health care onto the worker and consumer. Progressives disagree. Progressives, and I mean true progressives, hold that everyone must pay so that the costs and the risks are spread as widely as possible. This reduces the costs for everyone and everyone is covered.

More to the point, progressives understand that business seeks profits and one way to increase profits is to shift the cost of health care onto someone else. A universal health care system financed by taxes on all forms of income is the best way to make it possible. By imposing a small tax on all forms of income, the costs are spread thin enough that everyone can afford to pay into it.

Part of the reason why health care costs have been so high is that the health care industry, including the insurance industry figured out they could buy the influence they needed to avoid accountability. Let me give you an example of what I mean. Try estimating the cost of any procedure before you actually do it. I've done this. I needed to get something done, a surgery, and I called the hospital and the insurance numerous times and could not get a firm answer on my out of pocket costs for the surgery. It was not until the work was done and paperwork was processed that I was able to get answer. What kind of market is that? It's not a free market, it's an obscured market. This is a result of public policy decisions, not the free market, whatever that might be.

In a transparent market, we know what the costs are before we go in. We can do comparison shopping before we go in. The experience I had tells me that the costs are obscured by design and for a reason: to keep the patient in the dark. If the patient knew how much it would truly cost, including out of pocket expenses, the surgery would not get done. Worse, it allows the health care industry to land a debt on a patient. Interest on debts just means more money for the health care industry.

A universal health care system means that when any player in the system attempts to shift the cost burden upon someone else, everyone else notices. Properly designed, the cost of health care cannot be shifted upon someone else because everyone pays into it. All of the data goes into one system, generating statistics to show who is playing fair and who is not. A universal health care system will make it hard for the Epipens and Sovaldis to withstand competition, too. In a universal health care system, the government can compare pricing among products and services in a way that insurers and ordinary people cannot. They can also compare outcomes and use empirical evidence to determine the most effective treatment for any ailment.

The primary argument missing from the health care debate is that not everyone has an equal opportunity for access. To begin with, not everyone starts with the same opportunities when they enter the health care system. Nobody chooses to have an accident, an addiction, a cancer or an occupational hazard. Nobody chooses to bath in polluted water, risk a natural disaster, or eat food that is poisoned by insecticides. No one has the money to escape all risks, its simply not possible. Insurance was invented to spread the risks.

We are all doing the best we can. The person I save or help through a socialized health care system may be the one to help me someday. But it only works if we all pay in.

Yes, a universal health care system is a lot of power to give to a government, but European governments have done well with socialized medicine. So has Japan. Every major industrialized country provides health care as a right, except us, so we know it can be done. There is no reason we cannot do it, except for a lack of political will. Who lacks the political will do make this happen? The people with the most influence on government: the top 1%.

The best shot we have at universal health care is HR 676. HR 676 solves a problem created by public policy decisions made over the last 30-40 years. Who has the most influence over public policy at the national level (and probably the state level, too)? The wealthiest individuals and companies in the country. We know this because the empirical evidence proves it.

"Testing Theories of American Politics: Elites, Interest Groups, and Average Citizens" is a study that proves without a doubt that the top 1% and the wealthiest corporations and organized business interests have the most sway with Congress. To put it bluntly, big money rules Congress. Where does big money come from? Big businesses and the people who run them. Some people call them "oligarchs".

The goal then is to lay the problem at the feet of the oligarchs and demand universal health care as proposed by HR 676 (or something like it) as a solution, and no less. Let the oligarchs explain why we should not have universal health care. Let the oligarchs justify why people should go bankrupt for health care. Let the oligarchs justify why people should die for lack of money for health care.

Respondeat superior, or, "let the master answer".

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