Socialized Medicine

Nicholas Kristof, who is rapidly pulling ahead of Gail Collins as my favorite New York Times columnist, today talked to Wendell Potter, former spinner for Cigna, the health insurance concern, now reformed.

Potter was one of the people responsible, at Cigna and before that Humana, for the meme that the Big Bad Gubmint is going to socialize our healthcare. And that this would be bad.

Would that it would happen, though! That would mean all citizens would have access to healthcare, including the sick, minorities, and the self-employed. This would be good for everyone, wouldn’t it? If people could get care when they’re sick, even if they don’t get a wage or salary—not just unemployed, I mean contractors and entrpreneurs of all sorts, any dreamer of the American Dream—they would be able to contribute to society rather than being a drain on it, such as by taking up space in a pauper’s grave. Healthy people are the ones who put into society, and society benefits proportionally from keeping them healthy.

Right now, Kristof says, the health insurance companies’ business model involves not insuring people. Possibly one of the few businesses, in fact, in which it’s considered perfectly ethical—even, according to the column, grounds for a perfect performance review—to take customers’ money and provide nothing in exchange. Even a casino offers better odd than that. But insurers frequently “seiz[e] upon a technicality to cancel the policy of someone who has been paying premiums and finally gets cancer or some other expensive disease.” In any other field, that would be un-American. In health insurance, apparently, it’s the American way.

The socialized medicine meme, alas, is fiction, a lie created to scare people into acting against their own interests. None of the half-dozen or so plans floating around involves anything like socialism, unless your definition is “something and I don’t like it.” But socialized medicine is what would help people.

If that’s what you’re interested in.

Action Alert: Save Organic Food

I’m eating sliced steak en croute with organic flour and organic butter and quite possibly organic meat, I don’t recall.

This may or may not be particularly laudable. But soon it could be impossiblle.

Two months ago I wrote about HR2749, the Food Safety Enhancement Act of 2009. This is an attempt by theFederal government to kill small and organic farms, whether or not that’s what supporters believe they want to do. What there’s no indication it’ll do is enhance food safety in any meaningful way.

Nothing I mentioned then has changed (including the unfortunate preponderance of crazy people opposing it), but it is has passed the House of Representatives, with the Senate expected to vote after the August recess. The time to act is now. If you’re American and support small, independent farms, and support organic and sustainable agriculture, contact your senators, and tell them to oppose this bill. It’s not too late.

Some Facts on Health Care

I had a computer issue the last couple of days, so I’m making Thursday’s post today.

Meanwhile, people have been lining up on their sides of the health care reform “debate” (despite there being no valid case for leaving the current system untouched). Former NY Lieutenant Governor Betsy McCaughey so thoroughly collapsed on The Daily Show (the highlight for me was her reading sections of the bill out loud and then completely misrepresenting what they said) that it cost her her job at Cantel Medical Corp, albeit supposedly because they suddenly noticed she’d been involved in the debate since February. Lou Dobbs toured such desolate realms as the United Kingdom, Japan, and Canada and saw the dead and dying piled up six high in the streets except, you know, in reality. Roger Ebert expressed his support for the public option and was told it’s bad because it’s socialism and socialism is bad because it’s socialist. Or something like that.

What I haven’t seen is an argument against insuring sick people. I am inadequately insured. Why should I go untreated? No, tell me, I really want to know. It’s a hereditary, chronic illness, so it’s not like I went out and got myself sick in a fiendish plot to make other people pay for it. I don’t think anyone does that, actually. You’re left arguing against insuring the Wrong Sort, which does seem Republican, come to think of it, but the people shouting speakers down at town hall meeting often are what they would call the wrong sort (except for race, of course).

Again, I haven’t seen any explanation of what’s good about the current system. It leaves some people unable to access healthcare when they need it, and it puts preventative care—so they don’t need more and more expensive care later—out of reach of 47 million Americans. It needs to be changed; it needs to be improved. And lying about what that means helps no one.

Ross Douthat is Wrong About Everything

In particular, he’s wrong about healthcare reform. Ok, not everything; in 800 words he’s bound to hit something that accords with reality. But on the whole he has the wrong idea about what healthcare reform is, why we need it, and what will happen without it.

By ROSS DOUTHAT

Okay, so far so good.

When Democratic congressmen dream these days, they’re tongue-tied in town halls, fumbling with their microphones while they’re shouted down by slavering, pitchfork-wielding Limbaugh listeners.

Ross, darling, I’m fairly sure those are nightmares. Their dreams involve sick people in the country with, I’m told, the best doctors in the world being able to get quality medical treatment by leaping no higher hurdle than needing it. And apricot preserves, for some reason, but that’s not important right now.

But Barack Obama is wiser than most Democratic congressmen, and his nightmares are savvier. Instead of right-wing protesters, he dreams about old people.

He’s in the White House briefing room, presiding over a health care press conference. In the front row are the ancients of the D.C. media, and behind them is a sea of septuagenarians: some in wheelchairs, some clutching walkers, some dragging dialysis machines and the rest holding up Medicare cards like lighters at a Doors concert.

And everybody has a question.

What the hell are you talking about, Ross? Obama is shlepping around the western third of this country answering questions about healthcare reform. Since the only possible sense I can make out of this paragraph is that he’s somehow trying to slip something past the American people, what is this whistlestop tour about if not answering questions? (That link is from the super-secret underground publication The New York Times; you can’t expect a Times columnist to be familiar with it.)

If the Democratic Party’s attempt at health care reform perishes, senior citizens will have done it in, not talk-radio listeners and Glenn Beck acolytes. It’s the skepticism of over-65 Americans that’s dragging support for reform southward. And it’s their opposition to cost-cutting that makes finding the money to pay for it so difficult.

Yeah, I’ve seen the same videos he has—well, probably not, but I’ve seen the same videos he’s been able to, and I’m not seeing a lot of elderly retirees. A lot of people (particularly the armed ones) look about my age, and I’ve got a ways to go before I hit Medicare age.

That’s because they’re the ones whose benefits are on the chopping block. At present, Medicare gives its recipients all the benefits of socialized medicine, with few of the drawbacks. Once you hit 65, the system pays and pays, without regard for efficiency or cost-effectiveness.

There’s an obvious sarcastic remark I can make here, but I don’t want to be taken out of context. Let’s just say that “cost-effectiveness” shouldn’t apply broadly to health insurance, because it’s never okay to let someone die if they don’t want to.

For liberals trying to find the money to make health insurance universal, these inefficiencies make Medicare an obvious place to wring out savings. But you can’t blame the elderly if “savings” sound a lot like “cuts.” When the president talks about shearing waste from Medicare, and empowering an independent panel to reduce the program’s long-term costs—well, he isn’t envisioning a world where seniors get worse care, but he’s certainly envisioning a world in which they receive less of it.

“Cost-effectiveness” does narrowly apply to health insurance because we shouldn’t be spending money on things that aren’t helping at all. Providing care is never a waste of money, but that doesn’t mean we shouldn’t reduce the cost of providing care if it can be done without compromising quality.

Incidentally, the only person saying the Gubmint is gonna take your Medicare away is Ross Douthat and his cohorts and fellow travellers. I certainly haven’t seen anything of the sort in non-partisan explanations of the reform proposal.

This is politically perilous, to say the least — and Republicans have noticed.

Conservatives have marshaled various briefs against the Democratic health care proposals. They’ve argued that the plans will be too expensive, that they’ll cramp innovation and raise premiums for the already-insured, that they’ll encourage employers to drop coverage and discourage them from hiring.

These arguments have been effective, up to a point. But they aren’t nearly as effective as warning senior citizens that Barack Obama wants to take away their health care.

I notice that “effective” isn’t the same as “sound.” But if a system that ensures everyone, regardless of whether they can get employment through their work, encourages employers to drop insurance, so what?

That’s why Republicans find themselves tiptoeing into an unfamiliar role—as champions of old-age entitlements. The Democrats are “sticking it to seniors with cuts to Medicare,” Mitch McConnell declared. They want to “cannibalize” the program to pay for reform, John Cornyn complained. It’s a “raid,” Sam Brownback warned, that could result in the elderly losing “necessary care.”

The controversy over “death panels” is just the most extreme manifestation of this debate. Obviously, the Democratic plans wouldn’t euthanize your grandmother. But they might limit the procedures that her Medicare will pay for. And conservative lawmakers are using this inconvenient truth to paint the Democrats as enemies of Grandma.

Again, says who? Other than conservative media and the people who get alll their news from talk radio and FOX News. The whole death-panels thing is a manufactured controversy, because there aren’t any. So it’s kind of pointless to debate them.

You can understand why Republicans, after decades of being demagogued for proposing even modest entitlement reforms, would relish the chance to turn the tables. But this is a perilous strategy for the right.

Medicare’s price tag, if trends continue, will make a mockery of the idea of limited government. For conservatives, no fiscal cause is more important than curbing this exponential growth. And by fighting health care reform with tactics ripped from Democratic playbooks, and enlisting anxious seniors as foot soldiers, conservatives are setting themselves up to win the battle and lose the longer war.

Maybe Republicans will be able to cast themselves as the protectors of entitlements today, and then impose their own even more sweeping reforms tomorrow. That’s the playbook that McConnell, Brownback and others seem to have in mind: first, save Medicare from Obama; then, save Medicare from itself.

The first part of this should be fairly easy.

But for now, their strategy means the country suddenly has two political parties devoted to Mediscaring seniors — which in turn seems likely to make the program more untouchable than ever.

Though it’s really only one: Republicans fearmongering about what they claim (baselessly) the Democrats will do and Republicans fearmongering about what they really do plan to do.

In this future, somebody will need to stand for the principle that Medicare can’t pay every bill and bless every procedure. Somebody will need to defend the younger generation’s promise (and its pocketbooks). Somebody will need to say “no” to retirees.

That’s supposed to be the Republicans’ job. They should stick to doing it.

Remember, caring about ones grandmother=liberal.

Deceptively Bareback

Not from the people who brought you liquid bandages, it’s the liquid condom.

No, really. It’s actually a gel that turns semisolid upon contact with semen, preventing HIV from passing through. The idea is to give women a way of preventing HIV transmission that doesn’t require her partner’s participation or even knowledge. This is particularly important in places where cultural values prevent men from using condoms and women from insisting they do so.

Now, I gotta say, I am unavoidably reminded of those cookbooks that teach you how to sneak vegetables into your kids’ meals. It may solve the immediate problem, but it won’t lead to a needed long-term change in behavior. (For the record, I always ate my vegetables. Indeed, as a child I was an angel and a delight. Now, not so much.)

In children, the problem is that, if they discover your devious ways, they stop trusting anything you eat, leading to dysfunctions of eating, and meanwhile they still don’t like vegetables. If domineering and recalcitrant lovers discover your devious ways, then, it may lead to dysfunctional sex, and meanwhile they still don’t like or think they should wear condoms. The problem here is men who are in denial about their role in HIV transmission, about how their attitudes and actions contribute to the epidemic.

The solution, as with children and vegetables, isn’t deception—it’s education.

(h/t Boonsri Dickinson)

Justice Sonia Sotomayor

The Senate did something that annoys the ever-living fuck out of me yesterday.

But y’know, I think I’m willing to forgive them. For now.

Yes, Yankee fan Sonia Sotomayor was confirmed. It was a foregone conclusion, even to the 31 Republicans who voted her down (possibly so they could tell their constituents “it wasn’t my fault”—though I notice at least one state’s senators voted in different ways). But it’s still the Obama Administration’s second major victory, and it was achieved easily enough that I’m cautiously optimistic about the next three and a half years. (I’m only cautiously optimistic about Sotomayor, for that matter, but it was a symbolic victory if nothing else.)

One reason for my optimism is that the hearings demonstrated just how out of touch Congressional Republicans are. Sotomayor isn’t unqualified unless your idea of “qualified” includes ideology—or sex or race. Ezra Klein said at the Prospect “Democrats had set up something of a trap for Republicans, where in order to oppose her nomination they would have to face down the headlights of history.” And face them they did, blithely redefining “racism” as the belief that white people aren’t superior to everyone else.

So, congratulations to Sonia Sotmayor on her confirmation.

The End of Science

More and more Americans are going without science in their lives. Or so they think.

A new article in The Nation discusses how science coverage is gradually disappearing from newspapers.

That would be, well, acceptable if science didn’t actually impact people’s lives whether they read about it or not. Thing is, most of the major issues that are part of our lives, and will be—epidemics, global warming, technology, terrorism and anti-terrorism—require science to understand and to make informed decisions about.

So it’s a problem that Americans aren’t getting, and in large part don’t seem to really want, the information needed to make those decisions.