Frequently Asked Drone Questions on Health Care

At least once a week, someone hops onto a post on this site that’s a few months old, and posts a few pages out of the Frank Luntz scare tactics memo.  I’m not quite sure I understand the impulse.  I generally don’t go looking for blogs that talk about how awesome free trade and deregulation is and post comments like, “Noooo!  We don’t want that!  Wake up, people!!!”

This week’s installment of Status Quo Drone Theater is someone who crafted a comment on a post from January.  It’s also a nice compendium of the ridiculous questions being peddled by House Republicans, Fox News, Rush and whoever else is part of the Anti-Reform Sound Machine these days.  And I couldn’t resist the way this commenter signed off, “Use your brains, Americans, before it is too late!!!!”

Well, OK.  I’ll use my brain.  But keep in mind, this creates a social obligation for you to start using yours.

Here are some questions that are worth consideration:

This is the truest statement in the comment, by the way.  Many of these questions are worth consideration, however dronishly phrased.

Why is Congress in such a hurry to pass health legislation?

Congress is busy trying to implement a health care reform package based on a campaign plan by Barack Obama submitted in May 2007.  In the past two years, it has been widely dissected on everything from blogs to the New England Journal of Medicine, and was talked of in part or in whole in over 20 Democratic candidate televised debates, and three debates with John McCain.  The roughest sketch of the Senate Finance Committee bill were released eight months ago, and we’ve been in constant hearings and closed door sessions since the stimulus bill passed on one or all committees.

It’s hard to figure out how this possibly qualifies as a hurry.

But if you need a little more to go on, try the fact that for every 1 percent increase in the unemployment rate, 1.1 million people lose their insurance.  Want to guess how much unemployment has jumped in the past two years?

If our health care is so bad, why do people come here for procedures from other countries who have government controlled health care? (e.g.Great Britain and Canada?)

Generally speaking, they don’t – at least not more often that our own citizens flee our health care systems to get their procedures done at a cheaper rate overseas.  By the way, you know how you used to put your tooth under your pillow for the Tooth Fairy?  Uh, well...

Also, Great Britain?  Ma'am, if British people don’t like the care they’re getting, they don’t come here!  They go to France.

Will Congress dissolve their own health care programs and opt for the same one that they are imposing on the rest of us?

I’m sure they’d be amenable, but that’d be redundant since they’re trying to expand health care based on what members of Congress receive.

Here’s the thing I love about America, by the way.  You can turn on C-SPAN any time you like and see House Republicans railing against the inefficiencies of government-run health care schemes and how intolerable government health care will be.  And every single one of those yahoos has government-sponsored health care choices through the Federal Employee Benefits Plan.

That’s the model of what reformers are trying to create – to give us similar choices to what they have at a level of comprehensive benefits equivalent to what they receive.

Will Obama and his family be subject to the same rules and regulation as the rest of us will be in this health care bill?

Um… no.  As Commander-in-Chief, his health care will be daily provided by a doctor supplied by the Department of Defense.  Meaning yes, that’s right, President Obama is getting his share of socialized medicine, just like the rest of our troops.

I’m not saying this to be pejorative.  The Department of Defense controls health care spending with a single-payer in the Federal government, and directly employs the hospitals, doctors, nurses and clinics through which care is distributed.  That, by any definition, is a socialized medicine structure.  It works so well, we only reserve it for the best of the best – the active military and our nation’s veterans.

Will procedures, medications and tests be rationed, especially for the elderly?

As Christopher Beam from Slate points out, American health care is rationed already:  “it’s just rationing by income instead of by efficiency.”  For example, a RAND study says we get the recommended preventative care only 50% of the time.  For many, that’s because they can’t afford it.  For 50 million Americans, their health care is rationed to the point of not receiving it.  And, of course, Americans who have insurance frequently find their care denied because of denied approval, rescissions, dramatic increases in co-pays and lifetime maximum benefit.

So the answer is procedures, medications and tests are already rationed.  Fixing health care will alleviate the most unjust and arbitrary rationing that we already subject ourselves to.  The elderly on Medicare will likely see absolutely no change -- Medicare already has a formal, transparent process for determining what it covers and what it does not, which is more than I can say for for-profit insurance.

How much will it cost and how will this money be raised?

The best guess is $120 billion to $150 billion per year.  This new Federal spending is the equivalent of 6% of total health care spending each year, and about a third of what we spend on Iraq and Afghanistan.

The rules of this legislation operate as “pay as you go,” requiring it to be paid for in full with a combination of new revenue and cuts elsewhere.  President Obama has identified new revenue (in the form of a cap on charitable deductions for the top bracket) and areas of Medicare that can be trimmed or which don’t obviously lead to better health outcomes.  Other ideas mentioned include employer pay or play – requiring all but the smallest of businesses to either provide meaningful benefits or pay into a common fund – removing some or all of the tax exclusion on employer-sponsored benefits, rolling back the Bush Tax Cuts for the wealthiest 1% which are set to expire next year anyway (we’d only need about 1/3 of that money), putting a surcharge on stock transactions, or a national Value Added Tax, which is what most other countries use.  Far more important than new revenue is finding ways to cut where we can, since up to a 1/3 of our health care spending goes to test and procedures that don’t make us healthier.

There’ll be a lively debate on what we use.  Likely, we’ll combined options from the above.

In view of the current deficit spending by the Obama administration how can we afford this legislation?

First, you weren’t paying attention – there’s no deficit spending allowed on this.

Second, being lectured on deficit spending by conservatives is like being lectured on family values by Mark Sanford and Mike Enzi.

But to get to your larger point, if left untouched, health care will jump from 16% of our economy to 20% in less than ten years.  The number of uninsured will jump to 52 million in only a year and a half.  The average cost of a family plan is greater than a full-time minimal wage job.  The typical elderly couple needs to save $300,000 for health care expenses not covered by Medicare.

How can we afford not to fix health care?

If taxes are imposed on health care premiums, why would Union members be exempt from these taxes?

They wouldn’t be.  First of all, that tax is one of many options, and not the smart pick for how we’ll pay for it.  Second, Max Baucus said that off the cuff one time because unions were beating the crap out of him on the idea of eliminating the tax exemption.  In this case, offering to throw a starving dog a bone didn’t stop the barking.  Neither of the draft bills contain any language anything like this.

Where in the Constitution of the U.S. does it say that the Federal Government should be responsible for the health care of its citizens?

Article I, section 8.  “The Congress shall have power to lay and collect taxes, duties, imposts and excises, to pay the debts and provide for the common defense and general welfare of the United States…. To make all laws which shall be necessary and proper for carrying into execution the foregoing powers, and all other powers vested by this Constitution in the government of the United States, or in any department or officer thereof.”

Congress is empowered to provide for the general welfare.  Given that we’re dealing with matters which, if left unreformed, directly contribute to 18,000 deaths a year and over 60% of all personal bankruptcies, not to mention put the businesses contained within the United States at a competitive disadvantage to other countries like Japan, South Korea, Canada and the countries of Europe, I would say the general welfare of the United States is directly involved.

(Side note – you ever notice that people who ask “Where in the Constitution…” generally have never read article I section 8?)

Finally,  What "moron"  actually believes that the government is capable of administering such a program in a way that is transparent and without the waste,fraud and bureaucratic red tape that is part of anything the government does?

Well, I would ask what “moron” actually believes that a health insurance system that is more concerned about its stock price and maintaining a favorable “medical loss ratio” by denying care to those who paid its premiums is what we should be enslaved to?

Here’s the beauty of the public health insurance option, by the way.  I think public coverage of the quality of Medicare or the VA is inherently going to be better than anything the private, for profit industry can provide in terms of cost or quality.  You think private insurance is going to inherently better, without the waste, fraud and red tape (clearly you haven’t spent a lot of time dealing with pre-approvals or rescissions).  You know what – let’s test that!  Let’s put the best private insurance has to offer against the best public coverage has to offer.  Let’s let the people choose.  Hell, you can have your Aetna plan with a CEO making $20 million in total compensation at the same time I have my public plan where the top officer makes $191,300.  No one’s forcing you to stop being a “moron.”

Or are you afraid that the American people will actually use their brain for once and buy a plan concerned with cost, quality and making people healthier rather than the one concerned with raising premiums, finding reasons to exclude people, and making their stock portfolio healthier?

(Photo credit:  aprilandrandy on Flickr.)