Krugman, Sarcasm and Soylent Green: The Best of the Weekend

Every Sunday, I’ve taken to posting the best of the best – the three must-reads or must-watches that will really help you parse what’s going on.  During the presidential campaign, we took to calling the period where the importance of what was covered was in inverse proportion to the frequency with which it was covered “silly season.”  This week, the focus seemed to be on – well – beers at the White House.  ‘Nuff said.

So here are the three weekend articles you won’t want to miss to remove some of the silliness from your coverage.  As we move into August, the misinformation begins to fly.  Most of it will be reported as “he says/she says” by the news – two sides of an argument that deserve equal weight.  But as these writers show, there’s a big difference.  One side is looking to address the problems of our broken health care system, and the other is trying to make it seem as confusing and hopeless as possible.

If there’s a silver lining, it’s that so many great writers are determined not to let the agents of the status quo have the last word.

1.)    Paul Krugman – “Health Reform Made Simple”

I’ve lost track of the number of people who have asked why there can’t be a simple 2 page description of what’s going on in health care reform and then, when I start to explain it in as simple terms as I know how, stop me with questions that get both deep and technical.  Of course, the deep, technical questions are how it’s supposed to be – participatory democracy should involve meat and not just baby food.   But it does point out an interesting fact – it’s easy enough to debate health care reform in a couple of hours or in a 100-page document.  It’s tough to debate it in a few minutes and 500 words.

But just as I comforted myself with that notion, Paul Krugman delivers the best and most succinct explanation of health care reform you can imagine.  And yes, it’ll take you minutes to read:

The essence is really quite simple: regulation of insurers, so that they can’t cherry-pick only the healthy, and subsidies, so that all Americans can afford insurance.  Everything else is about making that core work…

That’s it. Any commentator who whines that he just doesn’t understand it is basically saying that he doesn’t want to understand it.

Read the whole blog post here.

2.)    Jonathan Alter, “What’s Not to Like?”

Satire is the art of turning a preposterous argument on its head to demonstrate its truly silly core.  With this Newsweek article, subtitled “Reform? Why do we need health-care reform? Everything is just fine the way it is,” Alter undresses what is beginning to become a popular argument of saying the convoluted, wasteful, prohibitively expensive and abusive American health care system doesn’t need fundamental change.  It’s an argument so at odds with the experience of most Americans when dealing with an illness or injury that it deserves what Alter gives it – sarcasm:

I had cancer a few years ago. I like the fact that if I lose my job, I won't be able to get any insurance because of my illness. It reminds me of my homeowners' insurance, which gets canceled after a break-in. I like the choice I'd face if, God forbid, the cancer recurs—sell my house to pay for the hundreds of thousands of dollars in treatment, or die. That's what you call a "post-existing condition."

I like the absence of catastrophic insurance today. It meant that my health-insurance plan (one of the better ones, by the way) only covered about 75 percent of the cost of my cutting-edge treatment. That's as it should be—face cancer and shell out huge amounts of money at the same time. Nice…

Speaking of fair, it seems fair to me that cost-cutting bureaucrats at the insurance companies—not doctors—decide what's reimbursable. After all, the insurance companies know best.

Read the whole article on Newsweek's site.

3.)    The White Coat Underground, “Health Care Reform – How to Obfuscate, Confuse and Inflame”

I wasn’t following this blog but, after this post, it’s a must have on my RSS reader.  PaulMD is an internist in the Great Lakes region, and he knows malarkey when he sees it.  The new constant refrain (the new “socialized medicine is bad,” if you will) of those who would like to continue profiting financially and/or politically from the current inefficiencies of our health care system goes something like this:  the government will overrule your doctor.  The supposed villain is comparative effectiveness research.  Well, it just so happens that PaulMD is a doctor.  His diagnosis of this fear-mongering argument?  It’s baloney:

How does [Betsy McCaughey] justify this unjustifiable conclusion? She doesn't. She simply asserts it. "Comparative effectiveness" is an au courant term used to describe research that looks at medical practices and tried to assess its effects. For example, there are two surgical ways to fix blood flow to the heart muscle: percutaneous coronary interventions (PCIs) such as angioplasty and stenting, and coronary artery bypass grafting (CABG or "heart bypass"). I'm not going to teel you which one is better, because the answer is complicated and still being investigated, but to choose the correct therapy for a patient we must answer a number of questions: which works best in which kind of patient; how long does each last; which has lower complication rates; which leads to longer survival; which leads to longer survival without additional need for a second intervention; which costs more, and over what time period; which makes people feel and function better. These questions and others need to be asked about many of the things we do, and comparative effectiveness research is a reasonable way to approach this.

To ignore these questions because we don't like the answers is so frighteningly ignorant that it's hard to believe an intelligent person could suggest it. Knowing these answers doesn't mean it's time to start making Soylent Green. What we do with the information is where our ethics as individual and as a society are tested. If we find that kidney dialysis in eighty year olds on average does not provide much quality or quantity of life, do we decide to stop covering it? Do we create algorithms for deciding what do offer an individual? Do we make a subjective choice in each case?

Read the whole post here.

(Photo credit:  taekwonweirdo on Flickr.)